Endoscopic-Assisted Canal Wall-up Tympanomastoidectomy for Reduction of Residual Cholesteatoma

• Published in: International Archives of Otorhinolaryngology Vol. 26; no. 2; pp. e260 - e264
• Main Authors: Silva, Mauricio Noschang Lopes, Selaimen, Fábio André, Huve, Felipe da Costa, Koga, Fernanda Dias Toshiaki, Martins-Costa, Luciana Lima, Bergamaschi, João Augusto Polesi, Silva, Alice Lang, da Costa, Sady Selaimen
• Format: Journal Article
• Language: English
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01-04-2022; Fundação Otorrinolaringologia
• Subjects: cholesteatoma; endoscopic ear surgery; level of evidence: 3; Original; Original Article; OTORHINOLARYNGOLOGY; endoscopic ear surgery; level of evidence: 3; cholesteatoma
• ISSN: 1809-9777; 1809-4864; 1809-4864
• DOI: 10.1055/s-0041-1730455

Abstract
Introduction
 The treatment of cholesteatoma is generally surgical, and the major obstacle is the high prevalence of recidivism. The endoscopic ear surgery technique is proposed to minimize this problem.
Objectives
 To utilize endoscopes to visualize and manipulate cholesteatoma residues after microscopic removal
Methods
 Cross-sectional study. Thirty-two patients with cholesteatoma underwent microscopic wall-up mastoidectomy combined with the endoscopic approach. The subjects were assessed for the presence and location of covert disease.
Results
 Of the 32 cases, 17 (53.12%) had residual cholesteatoma in the endoscopic phase. Minimal disease was found, usually fragments of the cholesteatoma matrix. Pars tensa cholesteatomas had more covert disease than pars flaccida cholesteatomas (62.50% vs 43.75%). Posterior recesses (47.05%) and tegmen tympani (41.17%) were the locations with more covert disease (
p
 < 0.05).
Conclusion
 Cholesteatomas of the pars tensa presented more residual disease and were significantly more common in the posterior recesses and tegmen tympani.