Endoscopic transcanal surgery of pars tensa cholesteatoma: Preliminary results |
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| Affiliation: | 1. Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France;2. Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain;3. Hospital Universitario de Jerez, Jerez, Spain;4. Service of Otolaryngology, Foch Hospital, University of Paris Saclay, Paris, France;5. Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, ENT Department of University of Catania, Catania, Italy;6. London Health Sciences Centre – Victoria Hospital, Ontario, Canada;7. Rhinology and Skull Base Surgery Unit, Otolaryngology Department, University Hospital Virgen Macarena, University of Seville, Seville, Spain;8. Kasr Alainy School of Medicine, Cairo University, Egypt;9. Rhinology and Skull Base Surgery Unit, Otolaryngology Department, Hospital Ramon y Cajal, Madrid, Spain;10. Otolaryngology Department, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain;1. Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España;2. Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, España;3. UVIC. Universitat Central de Catalunya, Vic, España;4. Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España;1. Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España;2. Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, España;3. Universitat Central de Catalunya, Vic, España;1. Department of Otorhinolaryngology of Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Porto, Portugal;2. Department of Otorhinolaryngology of Hospital Senhora da Oliveira de Guimarães, Braga, Portugal |
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| Abstract: | Introduction and objectivesThe aim of the present study is the assessment of exclusive endoscopic ear surgery for the management of primarily acquired pars tensa cholesteatoma, which is commonly linked to the failure of the Eustachian tube leading to the formation of retraction pockets.Materials and methodsPatients suffering from primarily acquired pars tensa cholesteatoma, who underwent primary surgery in our clinic, between 2014 and 2018 were included in this retrospective study. The disease was classified according to the EAONO/JOS system. Exclusive endoscopic ear surgery was performed for patients without mastoid involvement, while a microscopic–endoscopic tympanoplasty was carried out in case of mastoid extension. We assessed the recidivism rate during the follow-up.ResultsCholesteatomas belonged to stage I in 28% of cases, to stage II in 68% and only one patient was stage III. Only a portion of the pars tensa was involved in 13 instances, the whole pars tensa in 3 and both the tensa and the flaccida in 9. 17 out of 25 patients underwent exclusive endoscopic ear surgery and 8 needed a combined approach. We discovered 1 recurrence and 6 residual diseases.ConclusionsWith only one case of recurrence in our series, we showed how pars tensa cholesteatoma cannot be exclusively explained through Eustachian tube dysfunction, but also through a ventilation blockage between the Eustachian tube and other mesotympanic areas due to the formation of intratympanic folds. Endoscopic ear surgery proved highly effective in the control of recurrences and it should be considered the treatment of choice. |
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| Keywords: | Cholesteatoma Endoscopic ear surgery Retraction pocket Mesotympanum Colesteatoma Cirugía endoscópica de oído Bolsa de retracción Mesotímpano |
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