Endoscopic-Assisted Canal Wall-up Tympanomastoidectomy for Reduction of Residual Cholesteatoma
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 af...
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| Published in: | International Archives of Otorhinolaryngology Vol. 26; no. 2; pp. e260 - e264 |
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| Language: | English |
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Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
Thieme Revinter Publicações Ltda
01-04-2022
Fundação Otorrinolaringologia |
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| Abstract | 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. |
|---|---|
| AbstractList | 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. 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. 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. 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. 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. |
| Author | Bergamaschi, João Augusto Polesi Selaimen, Fábio André Silva, Alice Lang da Costa, Sady Selaimen Koga, Fernanda Dias Toshiaki Silva, Mauricio Noschang Lopes Huve, Felipe da Costa Martins-Costa, Luciana Lima |
| AuthorAffiliation | 1 Department of Otolaryngology – Head and Neck Surgery, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil 2 Department of Otolaryngology and Ophthalmology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil |
| AuthorAffiliation_xml | – name: 1 Department of Otolaryngology – Head and Neck Surgery, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil – name: 2 Department of Otolaryngology and Ophthalmology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil – name: Universidade Federal do Rio Grande do Sul – name: Hospital das Clínicas de Porto Alegre |
| Author_xml | – sequence: 1 givenname: Mauricio Noschang Lopes orcidid: 0000-0002-3747-5398 surname: Silva fullname: Silva, Mauricio Noschang Lopes organization: Hospital de Clínicas de Porto Alegre – sequence: 2 givenname: Fábio André orcidid: 0000-0002-9209-2023 surname: Selaimen fullname: Selaimen, Fábio André organization: Department of Otolaryngology – Head and Neck Surgery, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil – sequence: 3 givenname: Felipe da Costa orcidid: 0000-0002-2859-4221 surname: Huve fullname: Huve, Felipe da Costa organization: Department of Otolaryngology – Head and Neck Surgery, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil – sequence: 4 givenname: Fernanda Dias Toshiaki surname: Koga fullname: Koga, Fernanda Dias Toshiaki organization: Department of Otolaryngology – Head and Neck Surgery, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil – sequence: 5 givenname: Luciana Lima orcidid: 0000-0002-4401-0505 surname: Martins-Costa fullname: Martins-Costa, Luciana Lima organization: Department of Otolaryngology – Head and Neck Surgery, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil – sequence: 6 givenname: João Augusto Polesi surname: Bergamaschi fullname: Bergamaschi, João Augusto Polesi organization: Department of Otolaryngology – Head and Neck Surgery, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil – sequence: 7 givenname: Alice Lang orcidid: 0000-0002-7616-2677 surname: Silva fullname: Silva, Alice Lang organization: Hospital de Clínicas de Porto Alegre – sequence: 8 givenname: Sady Selaimen orcidid: 0000-0003-3177-1687 surname: da Costa fullname: da Costa, Sady Selaimen organization: Department of Otolaryngology and Ophthalmology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil |
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| Cites_doi | 10.1016/j.ijporl.2014.12.008 10.1016/j.otc.2012.10.005 10.1177/014556130608500911 10.1097/00005537-200206000-00035 10.1097/MAO.0000000000000484 10.1016/j.otc.2012.12.002 10.1097/MAO.0000000000000948 10.1001/jamaoto.2015.3148 10.1002/lary.25261 |
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| Copyright | Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( ) 2021 Fundação Otorrinolaringologia. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
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| Keywords | endoscopic ear surgery level of evidence: 3 cholesteatoma |
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| References | A L James (ref6) 2016; 37 M Neudert (ref12) 2014; 35 S Ghaffar (ref4) 2006; 85 M Badr-El-Dine (ref10) 2013; 46 A Das (ref11) 2019; 00 R K Jackler (ref2) 2015; 125 M Tarabichi (ref9) 2013; 46 L S Rosito (ref3) 2016; 142 D Marchioni (ref7) 2015; 79 TdeO Lima (ref8) 2013; 79 S S da Costa (ref5) 2002; 112 S S Costa (ref1) 2006 Costa, SS; Cruz, OLM; Oliveira, JAA. 2006 Marchioni, D; Soloperto, D; Rubini, A 2015; 79 Lima Tde, O; Araújo, TF; Soares, LC; Testa, JR. 2013; 79 Jackler, RK; Santa Maria, PL; Varsak, YK; Nguyen, A; Blevins, NH. 2015; 125 Tarabichi, M; Ayache, S; Nogueira, JF; Al Qahtani, M; Pothier, DD. 2013; 46 Ghaffar, S; Ikram, M; Zia, S; Raza, A. 2006; 85 da Costa, SS; Lavinsky, M; Smith, MM. 2002; 112 Neudert, M; Lailach, S; Lasurashvili, N; Kemper, M; Beleites, T; Zahnert, T. 2014; 35 James, AL; Cushing, S; Papsin, BC. 2016; 37 Rosito, LS; Netto, LF; Teixeira, AR; da Costa, SS. 2016; 142 Badr-El-Dine, M; James, AL; Panetti, G; Marchioni, D; Presutti, L; Nogueira, JF. 2013; 46 Das, A; Mitra, S; Ghosh, D; Sengupta, A. 2019; 00 |
| References_xml | – start-page: 309 volume-title: Otorhinolaryngology (Principles and Practice) year: 2006 ident: ref1 contributor: fullname: S S Costa – volume: 79 start-page: 316 issue: 03 year: 2015 ident: ref7 article-title: Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: our experience publication-title: Int J Pediatr Otorhinolaryngol doi: 10.1016/j.ijporl.2014.12.008 contributor: fullname: D Marchioni – volume: 46 start-page: 211 issue: 02 year: 2013 ident: ref10 article-title: Instrumentation and technologies in endoscopic ear surgery publication-title: Otolaryngol Clin North Am doi: 10.1016/j.otc.2012.10.005 contributor: fullname: M Badr-El-Dine – volume: 85 start-page: 593 issue: 09 year: 2006 ident: ref4 article-title: Incorporating the endoscope into middle ear surgery publication-title: Ear Nose Throat J doi: 10.1177/014556130608500911 contributor: fullname: S Ghaffar – volume: 112 start-page: 1122 issue: 06 year: 2002 ident: ref5 article-title: Rock around the clock in the middle ear cleft publication-title: Laryngoscope doi: 10.1097/00005537-200206000-00035 contributor: fullname: S S da Costa – volume: 35 start-page: 1801 issue: 10 year: 2014 ident: ref12 article-title: Cholesteatoma recidivism: comparison of three different surgical techniques publication-title: Otol Neurotol doi: 10.1097/MAO.0000000000000484 contributor: fullname: M Neudert – volume: 46 start-page: 155 issue: 02 year: 2013 ident: ref9 article-title: Endoscopic management of chronic otitis media and tympanoplasty publication-title: Otolaryngol Clin North Am doi: 10.1016/j.otc.2012.12.002 contributor: fullname: M Tarabichi – volume: 37 start-page: 196 issue: 02 year: 2016 ident: ref6 article-title: Residual Cholesteatoma After Endoscope-guided Surgery in Children publication-title: Otol Neurotol doi: 10.1097/MAO.0000000000000948 contributor: fullname: A L James – volume: 142 start-page: 168 issue: 02 year: 2016 ident: ref3 article-title: Classification of Cholesteatoma According to Growth Patterns publication-title: JAMA Otolaryngol Head Neck Surg doi: 10.1001/jamaoto.2015.3148 contributor: fullname: L S Rosito – volume: 79 start-page: 505 issue: 04 year: 2013 ident: ref8 article-title: The impact of endoscopy on the treatment of cholesteatomas publication-title: Rev Bras Otorrinolaringol (Engl Ed) contributor: fullname: TdeO Lima – volume: 125 start-page: S1 issue: S 04 year: 2015 ident: ref2 article-title: A new theory on the pathogenesis of acquired cholesteatoma: Mucosal traction publication-title: Laryngoscope doi: 10.1002/lary.25261 contributor: fullname: R K Jackler – volume: 00 start-page: 1 year: 2019 ident: ref11 article-title: Endoscopic Versus Microscopic Management of Attic Cholesteatoma: A Randomized Controlled Trial publication-title: Laryngoscope contributor: fullname: A Das – volume: 37 start-page: 196 issue: 02 year: 2016 end-page: 201 article-title: Residual Cholesteatoma After Endoscope-guided Surgery in Children publication-title: Otol Neurotol contributor: fullname: James, AL; Cushing, S; Papsin, BC. – volume: 79 start-page: 505 issue: 04 year: 2013 end-page: 511 article-title: The impact of endoscopy on the treatment of cholesteatomas publication-title: Rev Bras Otorrinolaringol (Engl Ed) contributor: fullname: Lima Tde, O; Araújo, TF; Soares, LC; Testa, JR. – volume: 00 start-page: 1 year: 2019 end-page: 6 article-title: Endoscopic Versus Microscopic Management of Attic Cholesteatoma: A Randomized Controlled Trial publication-title: Laryngoscope contributor: fullname: Das, A; Mitra, S; Ghosh, D; Sengupta, A. – volume: 46 start-page: 211 issue: 02 year: 2013 end-page: 225 article-title: Instrumentation and technologies in endoscopic ear surgery publication-title: Otolaryngol Clin North Am contributor: fullname: Badr-El-Dine, M; James, AL; Panetti, G; Marchioni, D; Presutti, L; Nogueira, JF. – start-page: 309 year: 2006 publication-title: Otorhinolaryngology (Principles and Practice) contributor: fullname: Costa, SS; Cruz, OLM; Oliveira, JAA. – volume: 79 start-page: 316 issue: 03 year: 2015 end-page: 322 article-title: Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: our experience publication-title: Int J Pediatr Otorhinolaryngol contributor: fullname: Marchioni, D; Soloperto, D; Rubini, A – volume: 46 start-page: 155 issue: 02 year: 2013 end-page: 163 article-title: Endoscopic management of chronic otitis media and tympanoplasty publication-title: Otolaryngol Clin North Am contributor: fullname: Tarabichi, M; Ayache, S; Nogueira, JF; Al Qahtani, M; Pothier, DD. – volume: 142 start-page: 168 issue: 02 year: 2016 end-page: 172 article-title: Classification of Cholesteatoma According to Growth Patterns publication-title: JAMA Otolaryngol Head Neck Surg contributor: fullname: Rosito, LS; Netto, LF; Teixeira, AR; da Costa, SS. – volume: 85 start-page: 593 issue: 09 year: 2006 end-page: 596 article-title: Incorporating the endoscope into middle ear surgery publication-title: Ear Nose Throat J contributor: fullname: Ghaffar, S; Ikram, M; Zia, S; Raza, A. – volume: 112 start-page: 1122 issue: 06 year: 2002 end-page: 1125 article-title: Rock around the clock in the middle ear cleft publication-title: Laryngoscope contributor: fullname: da Costa, SS; Lavinsky, M; Smith, MM. – volume: 35 start-page: 1801 issue: 10 year: 2014 end-page: 1808 article-title: Cholesteatoma recidivism: comparison of three different surgical techniques publication-title: Otol Neurotol contributor: fullname: Neudert, M; Lailach, S; Lasurashvili, N; Kemper, M; Beleites, T; Zahnert, T. – volume: 125 start-page: S1 issue: Suppl 4 year: 2015 end-page: S14 article-title: A new theory on the pathogenesis of acquired cholesteatoma: Mucosal traction publication-title: Laryngoscope contributor: fullname: Jackler, RK; Santa Maria, PL; Varsak, YK; Nguyen, A; Blevins, NH. |
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Introduction
The treatment of cholesteatoma is generally surgical, and the major obstacle is the high prevalence of recidivism. The endoscopic ear... Introduction The treatment of cholesteatoma is generally surgical, and the major obstacle is the high prevalence of recidivism. The endoscopic ear surgery... Introduction The treatment of cholesteatoma is generally surgical, and the major obstacle is the high prevalence of recidivism. The endoscopic ear surgery... Abstract Introduction The treatment of cholesteatoma is generally surgical, and the major obstacle is the high prevalence of recidivism. The endoscopic ear... |
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| Title | Endoscopic-Assisted Canal Wall-up Tympanomastoidectomy for Reduction of Residual Cholesteatoma |
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