Eran Glikson1,2, Gilad Feinmesser3, Doron Sagiv3, Michael Wolf3,4, Lela Migirov4, Yisgav Shapira3,4. 1. Department of Otolaryngology, Head and Neck Surgery, Sheba Medical Center, 5262100, Tel-Hashomer, Israel. Eran.Glikson@sheba.health.gov.il. 2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Eran.Glikson@sheba.health.gov.il. 3. Department of Otolaryngology, Head and Neck Surgery, Sheba Medical Center, 5262100, Tel-Hashomer, Israel. 4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
PURPOSE: To evaluate clinical parameters, outcomes and complications of transcanal endoscopic ear surgeries (EES) and canal wall-up tympano-mastoidectomy (CWU) for middle ear cholesteatoma in children and to compare between the two surgical approaches. METHODS: A retrospective chart review of all children (< 16 years) who underwent surgery for cholesteatoma involving the middle ear only with a minimal follow-up period of 12 months. Demographic features, site and extent of disease, outcome and complications were reviewed and compared between the groups. RESULTS: Thirty EES and 19 CWU were included. The overall disease relapse rates in the EES and CWU groups were 20% (n = 6, residual rate = 10%, recurrence rate = 10%) and 47% (n = 9, residual rate = 11%, recurrence rate = 37%), respectively (p = 0.04), with mean duration of follow-up of 32.6 and 37.2 months, respectively. In the EES and CWU groups, the most common site of residual disease was the mastoid cavity/antrum (n = 2, 66% and n = 2, 100%, respectively). Most recurrences involved the epitympanum and extended into the tympanic cavity (n = 2, 66%) in the EES group and into the tympanic cavity, posterior mesotympanum and mastoid cavity/antrum (n = 3, 43%, each) in the CWU group. The overall complication rates in the EES and CWU groups were 10% (n = 3) and 11% (n = 2), respectively (p = 0.61). CONCLUSIONS: Endoscopic ear surgeries in children were found to be an acceptable and safe technique for the treatment of cholesteatoma limited to the middle ear cavity. A better overall success rate and a similar complication rate were found in the EES group when compared to CWU.
PURPOSE: To evaluate clinical parameters, outcomes and complications of transcanal endoscopic ear surgeries (EES) and canal wall-up tympano-mastoidectomy (CWU) for middle ear cholesteatoma in children and to compare between the two surgical approaches. METHODS: A retrospective chart review of all children (< 16 years) who underwent surgery for cholesteatoma involving the middle ear only with a minimal follow-up period of 12 months. Demographic features, site and extent of disease, outcome and complications were reviewed and compared between the groups. RESULTS: Thirty EES and 19 CWU were included. The overall disease relapse rates in the EES and CWU groups were 20% (n = 6, residual rate = 10%, recurrence rate = 10%) and 47% (n = 9, residual rate = 11%, recurrence rate = 37%), respectively (p = 0.04), with mean duration of follow-up of 32.6 and 37.2 months, respectively. In the EES and CWU groups, the most common site of residual disease was the mastoid cavity/antrum (n = 2, 66% and n = 2, 100%, respectively). Most recurrences involved the epitympanum and extended into the tympanic cavity (n = 2, 66%) in the EES group and into the tympanic cavity, posterior mesotympanum and mastoid cavity/antrum (n = 3, 43%, each) in the CWU group. The overall complication rates in the EES and CWU groups were 10% (n = 3) and 11% (n = 2), respectively (p = 0.61). CONCLUSIONS: Endoscopic ear surgeries in children were found to be an acceptable and safe technique for the treatment of cholesteatoma limited to the middle ear cavity. A better overall success rate and a similar complication rate were found in the EES group when compared to CWU.
Authors: L Presutti; F M Gioacchini; M Alicandri-Ciufelli; D Villari; D Marchioni Journal: Acta Otorhinolaryngol Ital Date: 2014-06 Impact factor: 2.124