Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2026
The Role of Total Transcanal Endoscopic Modified Radical Mastoidectomy in Extensive Mastoid Cholesteatoma: A Preliminary Report.
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Tengku Kamalden Tengku Mohamed Izam, Kumarasamy Guhan, Misron Khairunnisak
Аннотация
INTRODUCTION: Mastoid cholesteatoma is classically managed through a postauricular mastoidectomy approach. With the increasing use of endoscopic techniques in otologic surgery, various middle ear diseases can now be managed endoscopically. Modified radical mastoidectomy (MRM) still has a role in managing extensive mastoid cholesteatoma.
OBJECTIVES: To evaluate the feasibility of total transcanal endoscopic modified radical mastoidectomy (TTEMRM) for mastoid cholesteatoma at a single tertiary center.
METHODS: This 5-year retrospective review included 16 patients involving 17 operated ears with extensive cholesteatoma involving the middle ear and mastoid cavity, as demonstrated on preoperative high-resolution computed tomography of the temporal bone. All patients underwent TTEMRM under general anesthesia between January 2019 and December 2023.
RESULTS: Complete removal of mastoid cholesteatoma was achieved by lowering the posterior canal wall through the TTEMRM approach. Two cases developed delayed-onset facial nerve paresis, both of which resolved completely with conservative management. No evidence of recurrence was observed in all but 2 cases. Two cases required revision surgery through a postauricular mastoidectomy approach because of recurrent cholesteatoma. Four cases were lost to follow-up.
CONCLUSION: TTEMRM appears to be a useful technique for selected cases of extensive mastoid cholesteatoma requiring an open-cavity approach. Avoidance of an external incision and excellent visualization of the surgical field are among the advantages of this procedure.
OBJECTIVES: To evaluate the feasibility of total transcanal endoscopic modified radical mastoidectomy (TTEMRM) for mastoid cholesteatoma at a single tertiary center.
METHODS: This 5-year retrospective review included 16 patients involving 17 operated ears with extensive cholesteatoma involving the middle ear and mastoid cavity, as demonstrated on preoperative high-resolution computed tomography of the temporal bone. All patients underwent TTEMRM under general anesthesia between January 2019 and December 2023.
RESULTS: Complete removal of mastoid cholesteatoma was achieved by lowering the posterior canal wall through the TTEMRM approach. Two cases developed delayed-onset facial nerve paresis, both of which resolved completely with conservative management. No evidence of recurrence was observed in all but 2 cases. Two cases required revision surgery through a postauricular mastoidectomy approach because of recurrent cholesteatoma. Four cases were lost to follow-up.
CONCLUSION: TTEMRM appears to be a useful technique for selected cases of extensive mastoid cholesteatoma requiring an open-cavity approach. Avoidance of an external incision and excellent visualization of the surgical field are among the advantages of this procedure.