Elfeky Alaa Eldin M, Khazbzk Alaa O, Nasr Wail F, Emara Tarek A, Elanwar Mohamed W, Amer Hazem S, Fouad Yasser A
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, 4419 Egypt.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1036-1039. doi: 10.1007/s12070-017-1084-7. Epub 2017 Feb 6.
To determine the impact of using otoendoscopy at the time of primary surgery of cholesteatoma in identifying hidden "cholesteatoma remnant". Study was prospective study. Setting was University tertiary care hospital. One hundred fifty, patients diagnosed clinically and by CT as having cholesteatoma, have been operated. 64 patients operated by using canal up technique and 86 patients operated by using canal down technique. Once all visible cholesteatoma was removed with standard microscopic techniques, otoendoscopy was utilized in every patient to identify any hidden "cholesteatoma remnant". Despite apparent total microscopic eradication of cholesteatoma of the operated cases, otoendoscopy at time of primary surgery revealed an overall incidence of hidden cholesteatoma remnants of 18%. The incidence of hidden cholesteatoma remnants identified by otoendoscopy was 23% in the canal up group and 14% in the canal down group. Otoendoscopy should be used as an adjunct with standard microscopic technique to identify hidden cholesteatoma remnants during surgery of cholesteatoma.
为确定在胆脂瘤初次手术时使用耳内镜检查对识别隐匿性“胆脂瘤残留”的影响。本研究为前瞻性研究。研究地点为大学三级护理医院。150例经临床诊断及CT检查确诊为胆脂瘤的患者接受了手术。64例患者采用耳道上技术手术，86例患者采用耳道下技术手术。在使用标准显微技术清除所有可见胆脂瘤后，对每位患者使用耳内镜检查以识别任何隐匿性“胆脂瘤残留”。尽管手术病例的胆脂瘤在显微镜下看似已完全清除，但初次手术时的耳内镜检查显示隐匿性胆脂瘤残留的总体发生率为18%。耳内镜检查发现的隐匿性胆脂瘤残留发生率在耳道上组为23%，在耳道下组为14%。在胆脂瘤手术中，耳内镜检查应作为标准显微技术的辅助手段，以识别隐匿性胆脂瘤残留。
