Pediatric endoscopic cholesteatoma surgery

Jacob B. Hunter, M. Geraldine Zuniga, Alex D. Sweeney, Natalie M. Bertrand, George B. Wanna, David S. Haynes, Christopher T. Wootten, Alejandro Rivas

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Objectives (1) To describe and review a single center's pediatric endoscopic cholesteatoma experience, including surgical and audiologic outcomes. (2) To assess the most common locations of residual cholesteatoma following endoscopic removal. Study Design Case series with chart review. Setting Tertiary otologic referral center. Subjects Patients <19 years of age who underwent cholesteatoma removal with either endoscopic or microscopic visualization. Methods In a comparison of patients who underwent total endoscopic ear surgery (TEES), combined endoscopic-microscopic surgery, or microscopic surgery, analyzed outcomes included locations and incidence of recurrent and residual cholesteatoma, complications, and audiometric testing. Results Sixty-six patients (mean age, 10.9 years; range, 4-18 years; 43.4% female) with 76 ears met inclusion criteria. The average overall follow-up was 18.8 months (range, 6.7-48.3). Forty-seven (61.8%) ears underwent microscopic removal of cholesteatoma; 29 (38.1%) ears underwent combined endoscopic-microscopic removal; and 8 (10.5%) ears underwent TEES removal. Significantly more mastoidectomies were completed in microscopic cases as compared with endoscopic cases (P =.049). Though second-look procedures occurred in 15 (51.7%) endoscopic cases and 10 (21.3%) microscopic cases (P =.006), the rate of residual disease was 20.0% and 40.0% in endoscopic and microscopic cases, respectively (P =.38). When controlling for preoperative hearing, only the air-bone gap for TEES demonstrated significant improvement (P =.009). No complications were noted. Conclusion The present report describes our experience with pediatric endoscopic cholesteatoma surgery, demonstrating similar hearing outcomes, rates of recurrence and residual disease, and complication rates as compared with traditional microscopic techniques.

Original languageEnglish (US)
Pages (from-to)1121-1127
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume154
Issue number6
DOIs
StatePublished - Jun 1 2016

Keywords

  • cholesteatoma
  • endoscopic ear surgery
  • ossiculoplasty
  • pediatric
  • tensor fold

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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