EXCLUSIVE ENDOSCOPIC CHOLESTEATOMA SURGERY.

Corresponding Author:
Dhakeswar Singh Potsangbam,
Singjamei Chingamakha, Heirangoithong Bazar,
Imphal-795001, Manipur, India.
E-mail: potsangbamdhakeswarsingh@gmail.com
         dhake7@yahoo.com

ABSTRACT

BACKGROUND

Microscopic ear surgery had been the mainstay of the cholesteatoma surgery. Canal wall up (CWU) surgeries were employed to allow water activities after surgery. Canal wall down (CWD) surgeries were employed to avoid second look surgery to avoid recurrences. Hidden areas like sinus tympani, facial recess were frequent areas of recurrences and combined approach by posterior tympanotomy through mastoid was improvised to address the residual cholesteatoma in hidden areas. But the recurrence rate of cholesteatoma remained high. Endoscopes were introduced in the 1990s. Endoscopes increased accessibility and the endoscope assisted cholesteatoma surgery improved the results and reduced recurrence rate of cholesteatoma. But surgery of cholesteatoma by endoscope remained confined to attic, aditus and small mastoid antrum.

MATERIALS AND METHODS

The current study is a retrospective descriptive study of 243 cases of exclusive endoscopic surgery of cholesteatoma disease, performed by the same surgeon in a span of 8 years in a medical college. The aim of the study was to define the exclusive endoscopic cholesteatoma surgery. The classification and grading of cholesteatoma was done as per Daniele Marchioni and Livio Presutti and the staging system of Telmesani et al modified by Daniele Marchioni and Livio Presutti. The cases comprised of cholesteatoma disease confined to attic, middle ear and mastoid. Cases were operated exclusively with Endoscopy.

RESULTS

All cases were operated exclusively with endoscopic trans-canal approach only in 191 cases and with extension by endoscopic endaural technique in 52 cases. All were done under local anaesthesia with sedation. Age group of cases was from 8-65 years (median age was 20 years). There were 182 males and 61 females. Follow up of cases were done from 12 months to 7 and half years. There were no cases of recurrence. Cavity problems were minimal.

CONCLUSION

Endoscope can be used as a stand-alone means of cholesteatoma surgery with improved results.

KEY WORDS

Cholesteatoma Surgery, Endoscopic, Exclusive.