Transcanal endoscopic management of epitympanic cholesteatoma: a promising technique

Arvind Varma, Aanchal Sahni


Background: The objective of the study was to evaluate the role of functional endoscopic ear surgery in epitympanic cholesteatoma removal.

Methods: This study included 15 cases of epitympanic cholesteatoma who underwent exclusive endoscopic surgeries for cholesteatoma removal in a tertiary care centre between December 2017 to May 2018. The improvement in hearing threshold and air bone closure was evaluated comparing the preoperative and postoperative audiogram. The incidence of recurrence and reperforation was noted postoperatively using otoendoscopy.  

Results: Post-surgery improvement in hearing threshold was observed. There was no incidence of recurrence and reperforation during the mean follow up period of 7.8 months.

Conclusions: Endoscopic removal of epitympanic cholesteatoma is more natural way of removal of disease with less post-surgery morbidity and recurrence. It has potential to be a promising tool for treatment of epitympanic cholesteatoma in future.



Cholesteatoma, Endoscopic ear surgery, Recurrence

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Jufas N, Patel N. Endoscopic ear Surgery. In: Lalwani AK, Pfister Markus MF. Recent advances in Otolaryngology Head and Neck surgery. Delhi: Jaypee Publishers; 2018;6:1-38.

Bennet ML, Zhang D, Labadie RF, Noble JH. Comparision of middle ear visualization with endoscopy and microscopy. Otol Neurootol. 2016;37:1-366.

Marchioni D, Mattioli F, Alicandri-Ciufelli M, Presutti L. Endoscopic approach to tensor folds in patients with attic cholesteatoma. Acta Otolaryngol. 2009;129:946–54.

Marchioni D, Mattioli F, Alicandri-Ciufelli M, Molteni G, Masoni F, Presutti L. Endoscopic evaluation of middle ear ventilation route blockage. Am J Otolaryngol Head Neck Surg. 2010;31:453–66.

Committee on Hearing, Equilibrium guidelines for the diagnosis, evaluation of therapy in Meniere’s disease. American Academy of Otolaryngology-Head and Neck foundation, Inc. Otolaryngol Head Neck Surg. 1995;113(3):181-5.

Presutti L, Gioacchini FM, Alicandri-Ciufelli M, Villari D, Marchioni D. Results of endoscopic middle ear surgery for cholesteatoma treatment: a systemic review. Acta Otorhinolaryngologica Italica. 2014;34:153-7.

Ho SY, Kveton JF. Efficacy of the 2-staged procedure in the management of cholesteatoma. Arch Otolaryngol Head Neck Surg. 2003;129:541-5.

Syms MJ, Luxford WM. Management of cholesteatoma: status of the canal wall. Laryngoscope. 2003;113:443-8.

Palva T, Ramsay H. Aeration of Prussak’s space is independent of the supradiaphragmatic epitympanic compartments. Otol Neurotol. 2007;28:264–2.

Tarabichi M. Endoscopic management of limited attic cholesteatoma. Laryngoscope. 2004;114:1157–62.

Migirov L, Shapira Y, Horowitz Z, Wolf M. Exclusive endoscopic ear surgery for acquired cholesteatoma. Preliminary results. Otol Neurotol. 2011;32:433–6.