Endoscopic Management of Chronic Otitis Media with Cholesteatoma

By June 7, 2019

Surmelioglu, Ozgur1; Dagkiran, Muhammed1; Ozdemir, Suleyman1; Tarkan, Ozgur1
1 Department of Otorhinolaryngology, Faculty of Medicine, Cukurova University, Adana, Turkey.

Endoscopic middle ear surgery was introduced into otology in the 1990s and has significantly changed surgical, anatomic, and physiologic concepts. Transcanal primary endoscopic ear surgery (EES) is indicated forcholesteatoma confined to the tympanic cavity without involving the mastoid.The present study examines this hypothesis and presents our experience with transcanal endoscopic ear surgery for middle ear cholesteatoma.

Rigid endoscopes (Hopkins telescope; Karl Storz, Tuttlingen,Germany) 4mm in diameter, 0, 30, 45, and 70 degrees were used routinely for all the procedures with a three-chip video camera (Karl Storz) and 20-inch high-resolution monitor. Endoscopes 2.7mm in diameter were used only when necessary owing to the limited view they provide.

Recently, the use of the endoscopes has led to new treatment options for middle ear pathologies. As described previously, the main advantage of the otologic endoscope is improved visualization and cholesteatoma eradication in  reviously difficult to access locations such as the posterior mesotympanum, sinus tympani, anterior epitympanic space, and the Eustachian tube. Therefore, it is hypothesized that this technique should reduce cholesteatoma recurrence.

EES, including detailed disease description, surgical results, and residual/recurrence sites. According to our results of all noted complications, although less invasive and with a lower complication rate than traditional surgeries, EES are not without complications.