Petrous Bone Cholesteatoma of Supralabyrinthine Type Removed by Transcanal Endoscopic Approach: Outcomes In 4 Cases

By June 7, 2019

Wang, Zhaoyan1,2,3; Chai, Yongchuan1,2,3; Zhu, Weidong1,2,3; Zhang, Zhihua1,2,3; Jia, Huan1,2,3;Hu, Lingxiang1,2,3; Wu, Hao1,2,3
1 Department of Otolaryngology Head & Neck surgery, Shanghai Ninth people’s Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai;
2 Ear institute, Shanghai Jiaotong University School of Medicine,Shanghai;
3 Shanghai Key Laboratary of Translational Medicine on Ear and Nose disease, Shanghai.

this study aimed to introduce our experience and outcomes of resection of supralabyrinthine PBC through totally transcanal endoscopic approach.

As a retrospective case study, resection of the limited supralabyrinthine PBC cholesteatoma via transcanal endoscopic approach was performed in four patients, including 2 males and 2 females. The mean age was 25.4 years . Preoperative estimations included enhanced MRI, HRCT, comprehensive hearing tests and endotoscopic examinations. Preoperative and postoperative facial nerve functions were graded according to the House-Brackmann (HB) scale.

The supralabyrinthine PBC in all 4 patients were removed clearly in one stage surgery. Three patients who had preoperative HB-I grade facial nerve function maintained in the postoperative period. For the patient with preoperative HB-III (cholesteatoma mainly involving horizontal segment of facial nerve and geniculate ganglion), the facial nerve recovered completely to HB-I grade at three months after operation. Before surgery, three patients had total hearing loss, and the other one with conductive hearing loss but cochlear was invaded on CT scan. No postoperative complications happened in all three patients. All these patients were discharged within five postoperative days, and no postoperative complications happened. During the follow-up period for the 4 patients , no recurrence of cholesteatoma on imaging evidences was found.

For the petrous bone cholesteatoma limited to supralabyrinthine type, transcanal endoscopic surgery is a safe and effective approach. Comparing to conventional microscopic surgery, this endoscopic approach is transcanal and less invasive, without huge resection of normal tissues and providing excellently postoperative outcomes.