DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20191746

Evaluating the role of otoendoscope in cholesteatoma surgery

Nitika Gupta, Mohinder Lal, Rohan Gupta

Abstract


Background: Endoscope assisted ear surgery (EAES) reduces the chances of residual cholesteatomas as compared to the conventional microscopic technique, primarily because of the direct visualization of sites where residual cholesteatoma is common, which is often missed out during the traditional microscopic surgical procedure. The aim of the study was to evaluate the hidden areas of middle ear using endoscopes during the conventional microscopic cholesteatoma surgery.

Methods: The present prospective study was carried out in the Dept. of Otorhinolaryngology and Head & Neck Surgery, Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Katra, Jammu for a period of one year during which a total of 20 patients of acquired cholesteatoma who underwent conventional microscopic surgery were followed by oto-endoscope assisted examination were enrolled.  

Results: Otoendoscope was used in all the surgeries to look for residual cholesteatoma in the hidden areas like protympanum, sinus tympani and anterior attic. An overall incidence of cholesteatoma observed and removed from hidden areas using otoendoscope was recorded to be 30% in the present study.

Conclusions: Microscopic ear surgery assisted with oto-endoscope allows a better visualization of the extent of cholesteatoma and thus improved eradication of residual/recurrent disease from the hidden areas of middle ear such as facial recess, sinus tympani, anterior epitympanic space, protympanum and hypotympanum.


Keywords


Otoendoscope, cholesteatoma, Microscope

Full Text:

PDF

References


Tarabichi M. Endoscopic management of cholesteatoma: long term results. Otolaryngol Head Neck Surg. 2000;122:874-81.

Rosenberg SI, Silverstein H, Willcox TO. Endoscopy in otology and neurotology. Am J Otol. 1994;15:168-72.

Tarabichi M. Endoscopic middle ear surgery. Ann Otol Rhinol Laryngol. 1999;108:39-46.

Barakate M, Bottrill I. Combined approach tympanoplasty for cholesteatoma: impact of middle-ear endoscopy. J Laryngol Otol. 2008;122:120-4.

Tarabichi M. Endoscopic management of limited attic cholesteatoma. Laryngoscope. 2004;114:1157-1162.

6. Glikson E, yousovich R, Mansour J, Wolf M, Migirov L and Shapira Y:transcanal endoscopic ear surgery for middle ear cholesteatoma.Otology, Neurotol. vol. 38 41-45 2017.

Badr-El-Dine M, James AL, Panetti G, Marchioni D, Presutti L, Nogueira J: Instrumentation and technologies in endoscopic ear surgery. Otolaryngol Clin North Am. 2013;46:211-25.

Alicandri-Ciufelli M, Marchioni D, Kakehata S,Presutti L and Villari D: Endoscopic Management of Attic Cholesteatoma Long-Term Results Otolaryngol Clin N Am. 2016;49:1265–70.

Sarcu D, Isaacson G. Long-term results of endoscopically assisted pediatric cholesteatoma surgery. Otolaryngol Head Neck Surg. 2016;154:535-9.

Presutti L, Gioacchini M, Alicandri-Ciufelli M, et al. Results of endoscopic middle ear surgery for cholesteatoma treatment: a systematic review. Acta Otorhinolaryngol Ital. 2014;34:153–7.

Toran KC, Shrestha S, Kafle P, Deyasi SK. Surgical management of sinus tympani cholesteatoma. Kathmandu University Medical J. 2004;2:297-300.

Livio Presulti MD, Daniele Marchioni MD, Domenico Villori, MD, and Matteo Alicandri-Cufelli MD. Endoscopic management of acquired cholesteatoma. J Otolaryngol Head Neck Surg. 2008;37(4):481-7.

Marchioni D, Mattioli F, Allicandri-Ciufelli M, Presutti L. Endoscopic approach to tensor fold in patients with attic cholesteatoma. Acta Otolaryngol. 2009;129(9):946-54.

Tarabichi M. Endoscopic management of limited attic cholesteatoma. Laryngoscope. 2004;114:1157-61.

Sajjadi H. Endoscopic Middle Ear and Mastoid Surgery for Cholesteatoma. Iranian J Otorhinolaryngol. 2013;2(25).

Ayubi S, Gill MZR. Oto-endoscopy for residual disease after radical and modified radical mastoidectomy for cholesteatoma. JUMDC. 2011;2:

Yung MY. The use of middle ear endoscopy; to check whether residual cholesteatoma was eliminated. J Laryngolog Otol. 2001;115:958-61.

Badr-El-Din MK. Endoscopic assisted surgery of sinus tympani cholesteatoma. Otol. 2009;5(2):158-65.

Badr-El-Din M. Value of ear endoscopy in cholesteatoma surgery. Otol Neurotol. 2002;23:631-5.