Silva Mauricio Noschang Lopes, Selaimen Fábio André, Huve Felipe da Costa, Koga Fernanda Dias Toshiaki, Martins-Costa Luciana Lima, Bergamaschi João Augusto Polesi, Silva Alice Lang, da Costa Sady Selaimen
Department of Otolaryngology - Head and Neck Surgery, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
Department of Otolaryngology and Ophthalmology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Int Arch Otorhinolaryngol. 2021 Oct 19;26(2):e260-e264. doi: 10.1055/s-0041-1730455. eCollection 2022 Apr.
The treatment of cholesteatoma is generally surgical, and the major obstacle is the high prevalence of recidivism. The endoscopic ear surgery technique is proposed to minimize this problem. To utilize endoscopes to visualize and manipulate cholesteatoma residues after microscopic removal Cross-sectional study. Thirty-two patients with cholesteatoma underwent microscopic wall-up mastoidectomy combined with the endoscopic approach. The subjects were assessed for the presence and location of covert disease. Of the 32 cases, 17 (53.12%) had residual cholesteatoma in the endoscopic phase. Minimal disease was found, usually fragments of the cholesteatoma matrix. Pars tensa cholesteatomas had more covert disease than pars flaccida cholesteatomas (62.50% vs 43.75%). Posterior recesses (47.05%) and tegmen tympani (41.17%) were the locations with more covert disease ( < 0.05). Cholesteatomas of the pars tensa presented more residual disease and were significantly more common in the posterior recesses and tegmen tympani.
胆脂瘤的治疗通常采用手术方式，而主要障碍是复发率高。有人提出采用耳内镜手术技术来尽量减少这一问题。
利用内镜在显微镜下切除后可视化并处理胆脂瘤残留物
横断面研究。32例胆脂瘤患者接受了显微镜下开放式乳突根治术联合内镜手术。对受试者进行隐匿性病变的存在情况及位置评估。
32例患者中，17例（53.12%）在内镜检查阶段有残留胆脂瘤。发现的病变较少，通常为胆脂瘤基质碎片。紧张部胆脂瘤比松弛部胆脂瘤有更多隐匿性病变（62.50%对43.75%）。后隐窝（47.05%）和鼓室盖（41.17%）是隐匿性病变较多的部位（P＜0.05）。
紧张部胆脂瘤残留病变更多，且在后隐窝和鼓室盖更为常见。
