Ear, nose, & throat journal · 2025
Endoscopic Control of Hard-to-Access Sites During Microscopic Cholesteatoma Surgery.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Körmendy Borbála, Illés Kata, Bajor Bence, Kálmán Judit, Sükösd Hunor, Horváth Tamás
Аннотация
PURPOSE: Residual cholesteatoma poses a great challenge in middle ear surgery. Considering that microscopes only offer line-of-sight vision, it was suggested earlier that endoscopes might prove useful to control difficult-to-visualize areas during surgery to ensure total evacuation of squamous epithelium. In this retrospective chart study, we evaluated intraoperative endoscopic findings of difficult-to-access sites in the tympanic cavity and postoperative cholesteatoma recidivism rate in these areas in a patient cohort who underwent primarily microscopic surgery.
MAIN FINDINGS: Residual cholesteatoma mass was intraoperatively detected in difficult-to-visualize areas using an endoscope during 50% of the procedures (10 cases), mostly in the sinus tympani (6 cases), but also in the supratubal recess (3 cases). During a mean follow-up of 36.1 months (range: 20-59 months, targeted magnetic resonance imaging [MRI] mean follow-up: 31.3 [range: 12-59]), recurrent attic cholesteatoma was found in 2 patients (10%), and residual disease was detected with dedicated MRI sequences in another 2 cases (10%). None of the residual cholesteatomas developed in the endoscopically controlled areas. The mean air-bone gap closure at 1 year was 1.9 ± 10.2 dB (range: -18.3-21.7).
CONCLUSIONS: Intraoperative endoscopic surveillance helps uncovering hidden cholesteatoma mass during routine microscopic surgery and thus offers an effective control of residual disease in these areas during a medium-term follow-up.
MAIN FINDINGS: Residual cholesteatoma mass was intraoperatively detected in difficult-to-visualize areas using an endoscope during 50% of the procedures (10 cases), mostly in the sinus tympani (6 cases), but also in the supratubal recess (3 cases). During a mean follow-up of 36.1 months (range: 20-59 months, targeted magnetic resonance imaging [MRI] mean follow-up: 31.3 [range: 12-59]), recurrent attic cholesteatoma was found in 2 patients (10%), and residual disease was detected with dedicated MRI sequences in another 2 cases (10%). None of the residual cholesteatomas developed in the endoscopically controlled areas. The mean air-bone gap closure at 1 year was 1.9 ± 10.2 dB (range: -18.3-21.7).
CONCLUSIONS: Intraoperative endoscopic surveillance helps uncovering hidden cholesteatoma mass during routine microscopic surgery and thus offers an effective control of residual disease in these areas during a medium-term follow-up.