Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Modena, Modena.
Otolaryngology Head & Neck Unit and Neurotological Unit, Alexandria Main University Hospital, Alexandria, Egypt.
Otol Neurotol. 2021 Feb 1;42(2):312-318. doi: 10.1097/MAO.0000000000002929.
The aim of this study was to report a multicentric surgical experience in the exclusive endoscopic management of glomus tympanicum (GT).
Retrospective case series review at two institutions.
Tertiary referral centers.
The study included 30 patients who underwent exclusive transcanal excision of GT between 2010 and 2017 at the two referral centers.
Exclusive endoscopic transcanal excision of GT type A1, A2, and B1 (modified Fisch-Mattox classification). All surgical procedures were performed by two senior surgeons (L.P.; M.B.).
For each procedure, intraoperative features of the disease, postoperative complications, and functional outcomes were evaluated. Recurrent or residual diseases were clinically and radiologically assessed during the follow-up period.
None of the patients treated with transcanal endoscopic approach (TEA) experienced intraoperative complications, nor required conversion to microscopic approach. Gross total resection (GTR) was obtained in 90% of the cases, while a near total resection was advocated when the residual pathology had a close relationship with the internal carotid artery. Mean hospitalization time was 1.6 (±0.8 SD) days and no postoperative complications were reported. No recurrences were reported in the GTR group after a mean follow-up period of 38.1 (±28.7 SD) months.
Middle ear paragangliomas with no mastoid involvement (Class A1, A2, and B1) can be safely managed by means of a transcanal endoscopic approach. Low rate of postoperative complications, short hospitalization, and high rate of gross total resection demonstrate that TEA is a safe and effective procedure.
本研究旨在报告一项关于鼓室球瘤（GT）的完全内镜治疗的多中心外科经验。
在两个机构进行的回顾性病例系列研究。
三级转诊中心。
本研究纳入了 2010 年至 2017 年期间在两个转诊中心接受完全经耳道切除 GT（改良 Fisch-Mattox 分类的 A1、A2 和 B1 型）的 30 例患者。
完全内镜经耳道切除 GT 型 A1、A2 和 B1（改良 Fisch-Mattox 分类）。所有手术均由两名资深外科医生（L.P.；M.B.）完成。
对于每种手术，评估术中疾病的特点、术后并发症和功能结果。在随访期间，通过临床和影像学评估复发或残留疾病。
采用经耳道内镜手术（TEA）治疗的患者均无术中并发症，也无需转为显微镜手术。90%的病例获得了完全切除（GTR），而当残留病变与颈内动脉关系密切时，主张进行近全切除。平均住院时间为 1.6（±0.8 SD）天，无术后并发症。在平均 38.1（±28.7 SD）个月的随访后，GTR 组无复发。
无乳突受累的中耳副神经节瘤（A1、A2 和 B1 型）可通过经耳道内镜手术安全治疗。低并发症发生率、短住院时间和高 GTR 率表明 TEA 是一种安全有效的手术方法。
