Endoscopic Hydro-Mastoidectomy in Cholesteatoma Surgery

By June 6, 2019

Suetaka, Nishiike1; Takao, Imai2; Kazuo, Oshima2; Satoru, Uetsuka1; Takahiro, Michiba1; Sho, Obata1; Shiori, Otani1; Naoki, Umeda1; 1Noa, Sasa1; Takanari, Kawabe1
1 Department of Otorhinolaryngology – Head and Neck Surgery, Osaka Rosai Hospital, Sakai, Japan;
2 Department of Otorhinolaryngology – Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.

Introduction:
To remove a cholesteatoma in the mastoid under transcanal endoscopic ear surgery, it is necessary to perform the transcanal endoscopic mastoidectomy. Bone dust and blood, however, obscure the surgical field. We developed a novel endoscopic hydro-mastoidectomy (EHM) technique to improve the surgical view during the mastoidectomy.

Methods:
A curved round coarse diamond bur is attached to an otologic drill. A lens cleaning sheath that provides saline perfusion in the surgical space is fitted to an endoscope. The operator performs the mastoidectomy underwater after filling the surgical space with saline water.

Discussion:
EHM washes out bone dust and blood from the surgical field. Additionally, the operator can easily control the flow of the saline perfusion. The setup for EHM is easy and the operator needs only to buy sheaths if they already own the power console, as many otologic and rhinologic surgeons do.

Conclusion:
EHM provides a clear surgical view by washing out bone dust and blood from the surgical area.