Transcanal Endoscopic Atticoplasty for Attic Cholesteatoma

By June 7, 2019

Cho, Hyong-Ho1; Kim, Hong-Chan1; Kim, Hee-Young1
1 Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea

Background and Objectives:
In treating attic cholesteatoma, traditional microscopic ap­proach provides limited exposure to the attic space. Recently, the use of endoscope has emerged as a new treatment option for attic cholesteatoma. The aim of this study is to report the prelimi­nary results of transcanal endoscopic removal of attic cholesteatoma and to evaluate the feasi­bility of endoscopic approach to attic cholesteatoma.

Subjects and Method:
Twenty-four patients with attic cholesteatoma were enrolled in this study from Oct 2015 to Oct 2018. Cholesteatoma was removed via transcanal endoscopic approach. Demographic data, operation time, postoperative admission days, pure tone audiometric results of pre-operation and post-operation at 3 months, and postoperative complications were evaluated.

Results:
All patients had attic cholesteatoma in the epitympanic space with scutum erosion. Preoperative air conduction hearing, bone conduction hearing and air-bone gap were 29.7 dB, 15.9 dB and 13.8 dB respectively, and there was no deterioration of hearing after endoscopic attic cholesteatoma surgery. According to the anesthesia, the mean operation time under general anesthesia and local anesthesia were 92 minutes and 66 minutes respectively. The mean postoperative admission period under general anesthesia and local anesthesia were 3.5 days and 2.9 days respectively. No surgical complications except effusion in middle ear were observed postoperatively, and favorable hearing out­come was obtained in all patients.

Conclusion:
Transcanal endoscopic ear surgery was successfully performed in patients with limited attic cholesteatoma. Further studies involving a large number of patients with long-term follow-ups are necessary to prove the clinical efficacy of transcanal endoscopic ear surgery in managing limited attic cholesteatoma.