Recidivism After Endoscopic Treatment of Cholesteatoma.

OBJECTIVE To investigate the recidivism rate of cholesteatoma treated via endoscopic ear surgery (EES), either via transcanal endoscopic ear surgery or endoscopic assisted tympanomastoidectomy compared with a microscopic postauricular approach. STUDY DESIGN Retrospective chart review. SETTING Academic otology practice. PATIENTS Adult patients (18 years and older) with at least 11 months of surgical follow-up who were treated for cholesteatoma via endoscopic techniques or microscopic postauricular approach. INTERVENTION Use of the endoscope for cholesteatoma dissection. MAIN OUTCOME MEASURE Residual or recurrent cholesteatoma identified at second look surgery or postoperative diffusion-weighted magnetic resonance imaging. RESULTS Fifty-nine patients treated for cholesteatoma via endoscopic techniques and 35 patients treated via microscopic postauricular approach were analyzed. The endoscopic group required significantly fewer mastoid procedures (28% versus 80%, p-value 0.001). Postoperative changes in median ABG (5 dB versus 3.75 dB, p = 0.9519), median PTA (6.875 dB versus 1.25 dB, p = 0.3864), and median word recognition score (0% versus 0%, p = 0.3302) were not significantly different between the EES and microscopic surgery groups. Median operative times were not significantly different between the two groups (182 min endoscopic versus 174 min microscopic, p-value 0.66). The rate of residual disease (17% EES versus 17% microscopic, p = 0.959) or disease recurrence (18% endoscopic versus 20% microscopic, p = 0.816) were not significantly different between the two groups. CONCLUSIONS EES is an effective option for cholesteatoma management with similar rates of recurrent or residual disease as compared with the more traditional microscopic postauricular approach in these samples.

[1]  Jacob B. Hunter,et al.  Primary Endoscopic Stapes Surgery: Audiologic and Surgical Outcomes. , 2018, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[2]  Samuel R. Barber,et al.  Development and validation of an endoscopic ear surgery classification system , 2018, The Laryngoscope.

[3]  G. Iannella,et al.  Endoscopic versus microscopic approach in attic cholesteatoma surgery. , 2018, American journal of otolaryngology.

[4]  B. Isaacson,et al.  Exclusive Endoscopic Transcanal Transpromontorial Approach for Vestibular Schwannoma Resection: A Case Series , 2017, Journal of Neurological Surgery Part B: Skull Base.

[5]  Daniel J. Lee,et al.  Temporal bone computed tomography findings associated with feasibility of endoscopic ear surgery. , 2017, American journal of otolaryngology.

[6]  Jacob B. Hunter,et al.  Audiometric Outcomes Following Endoscopic Ossicular Chain Reconstruction. , 2017, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[7]  Chih-Chieh Tseng,et al.  Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: A systematic review and meta‐analysis , 2017, The Laryngoscope.

[8]  B. Isaacson,et al.  Endoscopic Infracochlear Approach for Drainage of Petrous Apex Cholesterol Granulomas: A Case Series. , 2017, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[9]  L. Migirov,et al.  Transcanal Endoscopic Ear Surgery for Middle Ear Cholesteatoma. , 2017, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[10]  M. Cavaliere,et al.  Endoscopic tympanoplasty in the treatment of chronic otitis media: our experience , 2017, Acta oto-laryngologica.

[11]  Jacob B. Hunter,et al.  Endoscopic Management of Middle Ear Paragangliomas: A Case Series. , 2017, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[12]  D. Marchioni,et al.  Endoscopic Facial Nerve Surgery. , 2016, Otolaryngologic clinics of North America.

[13]  D. Marchioni,et al.  Endoscopic Management of Attic Cholesteatoma: Long-Term Results. , 2016, Otolaryngologic clinics of North America.

[14]  D. Marchioni,et al.  Results of endoscopic middle ear surgery for cholesteatoma treatment: a systematic review , 2014, Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale.

[15]  S. Kakehata,et al.  Extension of Indications for Transcanal Endoscopic Ear Surgery Using an Ultrasonic Bone Curette for Cholesteatomas , 2014, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[16]  K. Wilson,et al.  Tympanoplasty with Intact Canal Wall Mastoidectomy for Cholesteatoma , 2013, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[17]  D. Pothier,et al.  Transcanal endoscopic management of cholesteatoma. , 2013, Otolaryngologic clinics of North America.

[18]  R. Dobie,et al.  Letter to the Editor Response—Entong Wang , 2013, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[19]  Michael Wolf,et al.  Exclusive Endoscopic Ear Surgery for Acquired Cholesteatoma: Preliminary Results , 2011, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.