Endoscope-assisted surgery: a major adjunct in cholesteatoma surgery

Abstract

EnAbstractObjectiveThe purpose of this study was to evaluate the role of middle-ear endoscopy in the effective control over cholesteatoma through visualizing hidden areas of the middle-ear cleft.Materials and methodsA total of 60 ears with retraction pocket cholesteatoma were operated upon. They were subdivided into 40 cases operated upon using the canal wall up technique and another 20 cases operated upon using transcanal atticotomy. Endoscopically guided ear surgery was incorporated complementary to the microscope as a principal part in the procedure.ResultsThe incidence of cholesteatoma in the facial recess that was visualized by the endoscope was 25% compared with 20% by the microscope, whereas the incidence of detection of cholesteatoma in the sinus tympani by the endoscope was 35% compared with 5% by the microscope. Cholesteatoma in the anterior epitympanic recess was detected by the endoscope in 10% of ears compared with 0% by the microscope. In this series, no morbidity or complication was encountered secondary to the use of endoscopes in the mastoid or the middle ear.ConclusionEndoscope-assisted ear surgery has many benefits in cholesteatoma surgery as endoscopy helps explore hidden areas of the middle-ear cavity with a much lesser requirement for surgical exposure and the need to drill healthy bone; therefore, effective control over the disease can be achieved, thus establishing the concept of functional endoscopic ear surgery.