Tarabichi M
Division of Otolaryngology, American Hospital-Dubai, United Arab Emirates.
Otolaryngol Head Neck Surg. 2000 Jun;122(6):874-81. doi: 10.1016/S0194-59980070017-9.
This report evaluates long-term results of transcanal endoscopic management and surveillance of cholesteatoma.
Sixty-nine ears with acquired cholesteatoma underwent endoscopic transcanal tympanotomy and atticotomy to access and completely remove the sac. Reconstruction with a composite tragal graft was performed in 38 ears, and the cavities were packed open in 31 ears. Office-based endoscopic surveillance and follow-up were performed.
Forty-three ears were operated on with the patient under local anesthesia, and 58 were done on an outpatient basis. Three cases were converted into postauricular tympanomastoidectomy. There were no iatrogenic facial nerve injuries. Bone thresholds were stable, except in 1 patient with perilymphatic fistula. Mean follow-up was 41 months, and 19 ears underwent 5 years of follow-up. Six ears required revision surgery, and 9 required office-based minor procedures.
An endoscopic technique allows transcanal, minimally invasive management and surveillance of cholesteatoma with long-term results that compare well to those of postauricular methods.
本报告评估经耳道内镜治疗和监测胆脂瘤的长期效果。
对69例获得性胆脂瘤患者的耳朵进行内镜经耳道鼓室切开术和上鼓室切开术，以暴露并完全切除胆脂瘤囊。38耳采用复合耳屏移植物进行重建，31耳的术腔开放填塞。进行门诊内镜监测和随访。
43耳在局部麻醉下进行手术，58耳为门诊手术。3例转为耳后鼓室乳突切开术。无医源性面神经损伤。除1例有外淋巴瘘的患者外，骨导阈值稳定。平均随访41个月，19耳随访5年。6耳需要翻修手术，9耳需要门诊小手术。
内镜技术可实现经耳道微创治疗和监测胆脂瘤，长期效果与耳后手术方法相当。
