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Clinical Outcome of The Endoscopic Ear Surgery for Pars Tensa Cholesteatoma – World Congress on Endoscopic Ear Surgery

Clinical Outcome of The Endoscopic Ear Surgery for Pars Tensa Cholesteatoma

By June 7, 2019

Ito, Tsukasa1;Kubota, Toshinori1; Furukawa, Takatoshi1; Matsui, Hirooki1; Futai, Kazunori1; Kakehata, Seiji1
1 Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.

Introduction:
To improve surgical outcomes for cholesteatomas, we use either an endoscope alone as part of transcanal endoscopic ear surgery (TEES) or endoscope-assisted microscopic surgery. We have further employed an ultrasonic aspirator to extend the indications for TEES to treat cholesteatomas and collected data on clinical observations for pars tensa cholesteatomas.

Methods:
Study Design: Prospective case series.
Setting: University hospital.
Patients: Forty-five patients who underwent endoscopic surgery to treat pars tensa cholesteatoma between September 2011 and December 2016 (mean age/range: 57 yr/6–83 yr; 21 male/24 female; mean follow-up/range 38 m/1–78 m).
Intervention: Patients underwent either TEES or endoscope-assisted microscopic surgery.

Discussion:
Main Outcome Measures: We collected data on clinical staging based on the EAONO/JOS joint consensus statements, surgical procedures and surgical outcomes. (EAONO: European Academy of Otology and Neurotology, JOS: Japanese Otological Society)
Results: The cholesteatoma was localized in the tympanic cavity in 6 ears (13%); extended beyond the tympanic cavity in 26 ears (58%); and associated with extracranial complications in 13 ears (29%). TEES was performed in 37 ears (82%) with cholesteatomas extending up to and including the antrum. Canal wall up or canal wall down mastoidectomies were employed in 2 ears (4%) and 6 ears (13%) respectively for severe cholesteatomas. Twenty-two patients had a postoperative air-bone gap of less than 20 dB and a residual cholesteatoma was found in 4 patients among 41 patients over a one-year follow-up period.

Conclusion:
TEES with an ultrasonic aspirator achieved overall favorable outcomes for pars tensa cholesteatomas without perioperative complications.