DOI QR코드

DOI QR Code

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma

  • Park, Joo Hyun (Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan Hospital) ;
  • Ahn, Jungmin (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Moon, Il Joon (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2018.01.29
  • Accepted : 2018.04.20
  • Published : 2018.12.31

Abstract

Objectives. As endoscopic instrumentation, techniques and knowledges have significantly improved recently, endoscopic ear surgery has become increasingly popular. Transcanal endoscopic ear surgery (TEES) can provide better visualization of hidden areas in the middle ear cavity during congenital cholesteatoma removal. We aimed to describe outcomes for TEES for congenital cholesteatoma in a pediatric population. Methods. Twenty-five children (age, 17 months to 9 years) with congenital cholesteatoma confined to the middle ear underwent TEES by an experienced surgeon; 13 children had been classified as Potsic stage I, seven as stage II, and five as stage III. The mean follow-up period was 24 months. Recurrence of congenital cholesteatoma and surgical complication was observed. Results. Congenital cholesteatoma can be removed successfully via transcanal endoscopic approach in all patients, and no surgical complications occurred; only one patient with a stage II cholesteatoma showed recurrence during the follow-up visit, and the patient underwent revision surgery. The other patients underwent one-stage operations and showed no cholesteatoma recurrence at their last visits. Two patients underwent second-stage ossicular reconstruction. Conclusion. Although the follow-up period and number of patients were limited, pediatric congenital cholesteatoma limited to the middle ear cavity could be safely and effectively removed using TEES.

Keywords

Acknowledgement

Supported by : National Research Foundation of Korea (NRF)

References

  1. McGill TJ, Merchant S, Healy GB, Friedman EM. Congenital cholesteatoma of the middle ear in children: a clinical and histopathological report. Laryngoscope. 1991 Jun;101(6 Pt 1):606-13.
  2. Lim HW, Yoon TH, Kang WS. Congenital cholesteatoma: clinical features and growth patterns. Am J Otolaryngol. 2012 Sep-Oct;33(5): 538-42. https://doi.org/10.1016/j.amjoto.2012.01.001
  3. James AL. Endoscopic middle ear surgery in children. Otolaryngol Clin North Am. 2013 Apr;46(2):233-44. https://doi.org/10.1016/j.otc.2012.10.007
  4. Marchioni D, Soloperto D, Rubini A, Villari D, Genovese E, Artioli F, et al. Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: our experience. Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):316-22. https://doi.org/10.1016/j.ijporl.2014.12.008
  5. Potsic WP, Samadi DS, Marsh RR, Wetmore RF. A staging system for congenital cholesteatoma. Arch Otolaryngol Head Neck Surg. 2002 Sep;128(9):1009-12. https://doi.org/10.1001/archotol.128.9.1009
  6. Friedberg J. Congenital cholesteatoma. Laryngoscope. 1994 Mar; 104(3 Pt 2):1-24.
  7. Doyle KJ, Luxford WM. Congenital aural cholesteatoma: results of surgery in 60 cases. Laryngoscope. 1995 Mar;105(3 Pt 1):263-7. https://doi.org/10.1288/00005537-199503000-00008
  8. Chen JM, Schloss MD, Manoukian JJ, Shapiro RS. Congenital cholesteatoma of the middle ear in children. J Otolaryngol. 1989 Feb; 18(1):44-8.
  9. Sanna M, Zini C, Bacciu S. Surgery for cholesteatoma in children. In: Tos M, Thomsen J, Peitersen E, editors. Cholesteatoma and mastoid surgery. Amsterdam: Kugler and Ghedini Publication; 1989. p. 685-8.
  10. Migirov L, Shapira Y, Horowitz Z, Wolf M. Exclusive endoscopic ear surgery for acquired cholesteatoma: preliminary results. Otol Neurotol. 2011 Apr;32(3):433-6. https://doi.org/10.1097/MAO.0b013e3182096b39
  11. Kakehata S, Futai K, Sasaki A, Shinkawa H. Endoscopic transtympanic tympanoplasty in the treatment of conductive hearing loss: early results. Otol Neurotol. 2006 Jan;27(1):14-9. https://doi.org/10.1097/01.mao.0000181181.47495.a0
  12. Tarabichi M. Endoscopic management of acquired cholesteatoma. Am J Otol. 1997 Sep;18(5):544-9.
  13. Kobayashi T, Gyo K, Komori M, Hyodo M. Efficacy and safety of transcanal endoscopic ear surgery for congenital cholesteatomas: a preliminary report. Otol Neurotol. 2015 Dec;36(10):1644-50. https://doi.org/10.1097/MAO.0000000000000857
  14. Kozin ED, Gulati S, Kaplan AB, Lehmann AE, Remenschneider AK, Landegger LD, et al. Systematic review of outcomes following observational and operative endoscopic middle ear surgery. Laryngoscope. 2015 May;125(5):1205-14. https://doi.org/10.1002/lary.25048
  15. James AL, Cushing S, Papsin BC. Residual cholesteatoma after endoscope-guided surgery in children. Otol Neurotol. 2016 Feb;37(2):196-201. https://doi.org/10.1097/MAO.0000000000000948
  16. Hunter JB, Zuniga MG, Sweeney AD, Bertrand NM, Wanna GB, Haynes DS, et al. Pediatric endoscopic cholesteatoma surgery. Otolaryngol Head Neck Surg. 2016 Jun;154(6):1121-7. https://doi.org/10.1177/0194599816631941
  17. Ghadersohi S, Carter JM, Hoff SR. Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma. Laryngoscope. 2017 Nov;127(11):2653-8. https://doi.org/10.1002/lary.26654
  18. Hanna BM, Kivekas I, Wu YH, Guo LJ, Lin H, Guidi J, et al. Minimally invasive functional approach for cholesteatoma surgery. Laryngoscope. 2014 Oct;124(10):2386-92. https://doi.org/10.1002/lary.24633
  19. Levenson MJ, Parisier SC, Chute P, Wenig S, Juarbe C. A review of twenty congenital cholesteatomas of the middle ear in children. Otolaryngol Head Neck Surg. 1986 Jun;94(5):560-7. https://doi.org/10.1177/019459988609400605
  20. Kojima H, Tanaka Y, Shiwa M, Sakurai Y, Moriyama H. Congenital cholesteatoma clinical features and surgical results. Am J Otolaryngol. 2006 Sep-Oct;27(5):299-305. https://doi.org/10.1016/j.amjoto.2005.11.016
  21. Hidaka H, Yamaguchi T, Miyazaki H, Nomura K, Kobayashi T. Congenital cholesteatoma is predominantly found in the posterior-superior quadrant in the Asian population: systematic review and meta-analysis, including our clinical experience. Otol Neurotol. 2013 Jun; 34(4):630-8. https://doi.org/10.1097/MAO.0b013e31828dae89
  22. Kim YH, Yoo JC, Lee JH, Oh SH, Chang SO, Koo JW, et al. Stage progression of congenital cholesteatoma in children. Eur Arch Otorhinolaryngol. 2012 Mar;269(3):833-7. https://doi.org/10.1007/s00405-011-1737-1
  23. Darrouzet V, Duclos JY, Portmann D, Bebear JP. Congenital middle ear cholesteatomas in children: our experience in 34 cases. Otolaryngol Head Neck Surg. 2002 Jan;126(1):34-40. https://doi.org/10.1067/mhn.2002.121514
  24. Inokuchi G, Okuno T, Hata Y, Baba M, Sugiyama D. Congenital cholesteatoma: posterior lesions and the staging system. Ann Otol Rhinol Laryngol. 2010 Jul;119(7):490-4. https://doi.org/10.1177/000348941011900711
  25. Stapleton AL, Egloff AM, Yellon RF. Congenital cholesteatoma: predictors for residual disease and hearing outcomes. Arch Otolaryngol Head Neck Surg. 2012 Mar;138(3):280-5. https://doi.org/10.1001/archoto.2011.1422
  26. Yamatodani T, Mizuta K, Hosokawa K, Takizawa Y, Sugiyama K, Nakanishi H, et al. Congenital middle ear cholesteatoma: experience from 26 surgical cases. Ann Otol Rhinol Laryngol. 2013 May;122(5): 316-21. https://doi.org/10.1177/000348941312200505
  27. Marchioni D, Alicandri-Ciufelli M, Molteni G, Villari D, Monzani D, Presutti L. Ossicular chain preservation after exclusive endoscopic transcanal tympanoplasty: preliminary experience. Otol Neurotol. 2011 Jun;32(4):626-31. https://doi.org/10.1097/MAO.0b013e3182171007
  28. Tarabichi M. Endoscopic management of limited attic cholesteatoma. Laryngoscope. 2004 Jul;114(7):1157-62. https://doi.org/10.1097/00005537-200407000-00005
  29. Marchioni D, Alicandri-Ciufelli M, Piccinini A, Genovese E, Monzani D, Tarabichi M, et al. Surgical anatomy of transcanal endoscopic approach to the tympanic facial nerve. Laryngoscope. 2011 Jul;121(7): 1565-73. https://doi.org/10.1002/lary.21819
  30. Thomassin JM, Korchia D, Doris JM. Endoscopic-guided otosurgery in the prevention of residual cholesteatomas. Laryngoscope. 1993 Aug;103(8):939-43. https://doi.org/10.1288/00005537-199308000-00021
  31. Ito T, Kubota T, Watanabe T, Futai K, Furukawa T, Kakehata S. Transcanal endoscopic ear surgery for pediatric population with a narrow external auditory canal. Int J Pediatr Otorhinolaryngol. 2015 Dec; 79(12):2265-9. https://doi.org/10.1016/j.ijporl.2015.10.019
  32. Cohen MS, Landegger LD, Kozin ED, Lee DJ. Pediatric endoscopic ear surgery in clinical practice: lessons learned and early outcomes. Laryngoscope. 2016 Mar;126(3):732-8. https://doi.org/10.1002/lary.25410
  33. Kazahaya K, Potsic WP. Congenital cholesteatoma. Curr Opin Otolaryngol Head Neck Surg. 2004 Oct;12(5):398-403. https://doi.org/10.1097/01.moo.0000136875.41630.d6

Cited by

  1. Endoscopic Ear Surgery: Paradigm Shift or Subordinate Role? vol.12, pp.2, 2018, https://doi.org/10.21053/ceo.2019.00220
  2. Engineered oncolytic virus for the treatment of cholesteatoma: A pilot in vivo study vol.4, pp.5, 2018, https://doi.org/10.1002/lio2.307
  3. International Pediatric Otolaryngology Group (IPOG) Consensus Recommendations: Congenital Cholesteatoma vol.41, pp.3, 2018, https://doi.org/10.1097/mao.0000000000002521
  4. Middle ear congenital cholesteatoma: systematic review, meta-analysis and insights on its pathogenesis vol.277, pp.4, 2018, https://doi.org/10.1007/s00405-020-05792-4
  5. The Significance of Staging in the Treatment of Congenital Cholesteatoma in Children vol.100, pp.10, 2018, https://doi.org/10.1177/0145561320933965