Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: Our experience

Marchioni, Daniele; Soloperto, Davide; Rubini, Alessia; Villari, Domenico; Genovese, Elisabetta; Artioli, Franca Laura; Presutti, Livio

doi:10.1016/j.ijporl.2014.12.008

Cited by 90 publications

(54 citation statements)

References 41 publications

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“…Most importantly, most of the healthy structure and mastoid air cells can be preserved, as can the mucosal gas exchange and mastoid buffer, which are crucial for the restoration of the middle ear and the reduction of post-operative morbidity [2,6]. A congenital cholesteatoma, including the surrounding granulation or fibrotic band, was eradicated thoroughly with a high-resolution image and wide surgical .…”

Section: Discussionmentioning

confidence: 99%

“…These areas may have a number of hidden recess and sophisticated structures, and are difficult to navigate using the microscopic approach. Nevertheless, the TEES can offer a wider field of view to observe the corners of the middle ear, and is helpful in eradicating the lesions in the facial recess and sinus tympanum [2,3].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have reported that upper airway infection and otitis media may increase growth factors or matrix metalloproteinases, which can enable the cholesteatoma to become more invasive and destroy more of the surrounding structures [2]. Congenital cholesteatoma is managed through prompt surgical removal.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, more studies have demonstrated the benefits of TEES for the management of cholesteatoma in adult patients, including a clearer operation field, closer surgical views, and improved preservation of the mastoid air cells and ventilation function of the middle ear [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

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Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma: A Preliminary Report

Sun¹,

Kuo²,

Huang³

2017

AOHNS

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma: A Preliminary Report

Sun¹,

Kuo²,

Huang³

2017

AOHNS

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“…Delays in detection and surgery may extend the disease [ 2 ] so that CCs subsequently spread to poorly visualized retrotympanic regions that can make them difficult to remove [ 3 ]. Additionally, the higher prevalence of otitis media and upper respiratory infections in children increase the factors that promote cholesteatoma growth [ 4 ]. When they are detected, CCs should be removed completely without causing surgical complications.…”

Section: Introductionmentioning

confidence: 99%

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma

Park

Ahn

Moon

2018

Clin Exp Otorhinolaryngol

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Objectives As endoscopic instrumentation, techniques and knowledges have significantly improved recently, endoscopic ear surgery has become increasingly popular. Transcanal endoscopic ear surgery (TEES) can provide better visualization of hidden areas in the middle ear cavity during congenital cholesteatoma removal. We aimed to describe outcomes for TEES for congenital cholesteatoma in a pediatric population.Methods Twenty-five children (age, 17 months to 9 years) with congenital cholesteatoma confined to the middle ear underwent TEES by an experienced surgeon; 13 children had been classified as Potsic stage I, seven as stage II, and five as stage III. The mean follow-up period was 24 months. Recurrence of congenital cholesteatoma and surgical complication was observed.Results Congenital cholesteatoma can be removed successfully via transcanal endoscopic approach in all patients, and no surgical complications occurred; only one patient with a stage II cholesteatoma showed recurrence during the follow-up visit, and the patient underwent revision surgery. The other patients underwent one-stage operations and showed no cholesteatoma recurrence at their last visits. Two patients underwent second-stage ossicular reconstruction.Conclusion Although the follow-up period and number of patients were limited, pediatric congenital cholesteatoma limited to the middle ear cavity could be safely and effectively removed using TEES.

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Outcomes of Endoscopic Congenital Cholesteatoma Removal in South Korea

Choi

Kang

Lee

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceTranscanal endoscopic ear surgery (TEES) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility during cholesteatoma resection. However, the literature on outcomes following TEES alone for the removal of congenital cholesteatoma (CC) is lacking and limited to small series.ObjectiveTo assess outcomes of TEES for CC limited to the middle ear and/or mastoid antrum and to explore the risk factors associated with recidivism (ie, recurrent and/or residual cholesteatoma).Design, Setting, and ParticipantsThis cohort study evaluated retrospective, multicenter data for 271 children with CC who underwent TEES at 9 tertiary referral hospitals in South Korea between January 1, 2013, and December 31, 2021, and had a follow-up of at least 6 months after surgery.Main Outcomes and MeasuresOutcomes included the incidence of residual cholesteatoma and audiometric data after TEES. A multivariable analysis using Cox proportional hazards regression models was used to assess associations between cholesteatoma characteristics and recidivism, with hazard ratios (HRs) and 95% CIs reported.ResultsOf the 271 patients (mean [SD] age, 3.5 [2.9] years; 194 [71.6%] boys, 77 [28.4%] girls), 190 had Potsic stage I CC (70.1%), 21 (7.7%) had stage II, 57 (21.0%) had stage III, and 3 (1.1%) had stage IV. Thirty-six patients (13.3%) with residual cholesteatoma were found, including 15 (7.9%) with Potsic stage I, 3 (14.3%) with stage II, and 18 (31.6%) with stage III. In the multivariable analysis, invasion of the malleus (HR, 2.257; 95% CI, 1.074-4.743) and posterosuperior quadrant location (HR, 3.078; 95% CI, 1.540-6.151) were associated with the incidence of recidivism. Overall, hearing loss (&gt;25 dB on auditory behavioral test or &gt;30 dB of auditory evoked responses) decreased from 24.4% to 17.7% after TEES.Conclusions and RelevanceThis cohort study involved the largest known population to date of CC removed by TEES. The findings suggest that TEES may be feasible and effective for the removal of CC limited to the middle ear and/or mastoid antrum in children.

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Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: Our experience

Cited by 90 publications

References 41 publications

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma: A Preliminary Report

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma: A Preliminary Report

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma

Outcomes of Endoscopic Congenital Cholesteatoma Removal in South Korea

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