TY - JOUR
T1 - Pediatric endoscopic cholesteatoma surgery
AU - Hunter, Jacob B.
AU - Zuniga, M. Geraldine
AU - Sweeney, Alex D.
AU - Bertrand, Natalie M.
AU - Wanna, George B.
AU - Haynes, David S.
AU - Wootten, Christopher T.
AU - Rivas, Alejandro
N1 - Funding Information:
Grant support from the National Center for Advancing Translational Sciences / National Institutes of Health (UL1 TR000445) due to utilization of REDCap database for collection of patient data.
Publisher Copyright:
© Official journal of the American Academy of Otolaryngology-Head and Neck Surgery Foundation.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - 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.
AB - 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.
KW - cholesteatoma
KW - endoscopic ear surgery
KW - ossiculoplasty
KW - pediatric
KW - tensor fold
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U2 - 10.1177/0194599816631941
DO - 10.1177/0194599816631941
M3 - Article
C2 - 26932974
AN - SCOPUS:84973460052
SN - 0194-5998
VL - 154
SP - 1121
EP - 1127
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 6
ER -