The use of rigid endoscopes in cholesteatoma surgery.

The existence of blind pockets in the middle ear during cholesteatoma surgery could compromise complete removal of the disease, e.g. from the sinus tympanum. The use of side-viewing rigid endoscopes in conjunction with the operating microscope to control and facilitate cholesteatoma removal during mastoid operation was studied. Ninety-two primary operations for cholesteatoma over a four-year period were examined. Over one-third (35.9 per cent) of these cases had cholesteatoma extended into the sinus tympanum. Sixty-four operations were small cavity mastoidectomy. The others were either canal wall reconstruction or primary obliteration following open cavity mastoidectomy. Although residual cholesteatoma was found in three patients, only one was in the middle ear. It is concluded from this study that side-viewing endoscopes could be very useful in cholesteatoma surgery.