Efficacy and Safety of Transcanal Endoscopic Ear Surgery for Congenital Cholesteatomas: A Preliminary Report
Efficacy and Safety of Transcanal Endoscopic Ear Surgery for Congenital Cholesteatomas: A Preliminary Report
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DOI：
10.1097/mao.0000000000000857
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发表时间：
2015-12-01
影响因子：
2.1
通讯作者：
Hyodo, Masamitsu
中科院分区：
文献类型：
--
作者：
Kobayashi, Taisuke;Gyo, Kiyofumi;Hyodo, Masamitsu
目的：经鼻内镜耳手术（tee）在中耳病变切除术中提供比手术显微镜更大的视觉通路。本研究的目的是确定tee用于治疗儿童先天性胆脂瘤（CC）的安全性和有效性。研究设计：回顾性病例回顾。单位：三级转诊中心。患者：12例局限于中耳的CC患儿行tee。7个孩子是第一期，4个是第二期，1个是第三期。平均随访23.1个月。干预：内镜下经鼻中耳手术。主要观察指标：手术并发症及胆脂瘤复发率。结果：同期行tee手术12例，镜下手术4例。无手术并发症发生。12例患者中有7例的术后听音图可获得，其纯酮平均为3.3至23.9dB HL（平均为12.7dB HL）。一名III期CC患者在二次检查过程中发现残留疾病，随访期仅为3个月。其他患者接受一期手术，没有出现胆脂瘤复发。结论：虽然随访时间和患者数量有限，但早期CC可以安全地使用tee切除。
Objective: Transcanal endoscopic ear surgery (TEES) can provide greater visual access during resection of middle ear disease than the operating microscope. The purpose of this study was to determine the safety and efficacy of TEES when used for the management of congenital cholesteatoma (CC) in children.Study Design: Retrospective case review.Setting: Tertiary referral center.Patients: Twelve children with CC confined to the middle ear underwent TEES. Seven children were Potsic stage I, four were stage II, and one was stage III. The mean follow-up period was 23.1 months.Intervention: Transcanal middle ear surgery using endoscopes.Main Outcome Measures: Incidence of surgical complications and cholesteatoma recurrence.Results: Twelve patients underwent TEES and four patients underwent microscopic surgery during the same period. No surgical complications occurred. Postoperative audiograms were available for 7 of 12 patients who had puretone averages ranging from 3.3 to 23.9dB HL (mean, 12.7dB HL). One patient with a stage III CC was found to have residual disease during a second-look procedure, whose follow-up period was only 3 months. Other patients underwent one-stage operations and have developed no cholesteatoma recurrence.Conclusion: Although the follow-up period and number of patients were limited, early-stage CC can be safely removed using TEES.