Guo Lianrong, Su Yongjin, Cai Zhi, Yang Yuanyuan
Department of Otolaryngology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
Acta Otolaryngol. 2023 Feb;143(2):141-146. doi: 10.1080/00016489.2023.2176544. Epub 2023 Feb 24.
Transcanal endoscopic surgery offers advantages for congenital cholesteatoma (CC) which is expanding cystic mass located on an intact tympanic membrane.
To determine the efficacy of transcanal endoscopic ear surgery for the treatment of CC.
Eleven patients with CC confined to the middle ear underwent transcanal endoscopic ear surgery by surgeons who were skilled in otoscopic surgery. According to the Potsic classification, four, three, and four patients had lesions in stages 1, 2, and 3, respectively. The mean follow-up duration was 24.5 months. We retrospectively analyzed the recurrence rate, complications, and average hearing thresholds of the patients with CC.
All CCs were successfully resected the transcanal endoscopic approach, without any immediate or serious complications. The only complication was external auditory canal stenosis due to postoperative scarring, which occurred in a patient with a stage-3 cholesteatoma that recurred and required reoperation and second-stage ossicular chain reconstruction. Two more patients underwent one-stage ossicular chain reconstruction. All three patients received a total artificial ossicular replacement prosthesis, and two of them also received cartilage grafts.
Transcanal endoscopic ear surgery is an effective method to treat CC belonging to Potsic stages 3 or below.
经耳道内镜手术对于先天性胆脂瘤（CC）具有优势，先天性胆脂瘤是位于完整鼓膜上的扩张性囊性肿物。
确定经耳道内镜耳手术治疗CC的疗效。
11例局限于中耳的CC患者由擅长耳镜手术的外科医生进行经耳道内镜耳手术。根据波西克分类，分别有4例、3例和4例患者的病变处于1期、2期和3期。平均随访时间为24.5个月。我们回顾性分析了CC患者的复发率、并发症及平均听力阈值。
所有CC均通过经耳道内镜入路成功切除，无任何即刻或严重并发症。唯一的并发症是术后瘢痕导致的外耳道狭窄，发生在1例3期胆脂瘤复发且需要再次手术及二期听骨链重建的患者身上。另有2例患者接受了一期听骨链重建。所有3例患者均接受了全人工听骨置换假体，其中2例还接受了软骨移植。
经耳道内镜耳手术是治疗波西克3期及以下CC的有效方法。
