Kim, Hong Chan1; Cho, Yong Beom1
1 Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
The purpose of this study are to analyze the clinical characteristics of advanced congenital cholesteatoma (ACC), to evaluate the role of endoscopy in disease removal and recurrence in stage 3, 4.
We retrospectively reviewed 47 patients who were diagnosed as congenital cholesteatoma stage 3 and 4 at Chonnam National University Hospital from 2010 to 2017. Stage 3 meant ossicular involvement, stage 4 was disease with mastoid extension. Clinical characteristics of ACC were analyzed. We evaluated the recurrence rate and location according to the use of endoscopy in ACC.
The mean age at the diagnosis was 4.6 yeas old and showed a vertex at 3 years and 7years. 13 of 47 cases were treated with the transcanal endoscopic ear surgery (TEES) and the remaining 34 subjects were treated with tympanomastoidectomy (TM). 15 of 34 patients who underwent TM were identified by endoscopic examination to confirm remaining lesions. Incidence of recurrence was 3 cases in TEES, 9 in TM and 4 in endoscopic assisted TM. Location of recurrence was showed around stapes, tympanic segment of facial nerve and anterior epitympanum.
TEES is an efficacious and feasible method to remove congenital cholesteatoma in stage III. In addition, endoscopy is useful tool which shows better results in the removal of sinus tympani cholesteatoma.