Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma
Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma
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DOI：
10.1002/lary.26654
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发表时间：
2017-11-01
期刊：
影响因子：
2.6
通讯作者：
Hoff, Stephen R.
中科院分区：
文献类型：
--
作者：
Ghadersohi, Saied;Carter, John M.;Hoff, Stephen R.
目的描述三级儿科医院小儿胆脂瘤的内窥镜耳部手术（EES）的结果。方法对65例38只耳的小儿胆脂瘤病例进行回顾性病例系列分析。基于胆脂瘤类型和 EES 类型的亚组。对手术结果、结果和人口统计数据进行了评估。结果内窥镜用于 38 个原发耳的 65 例儿童胆脂瘤病例（34 名患者），随访平均 2.6 年（9 个月至 4.6 年）。内窥镜被用作 31 只 (81.6%) 耳朵 (EES 2 或 3) 的主要可视化工具，并作为 7 只耳朵 (EES 1) 显微镜的辅助工具。 22例（57.9%）耳和35例（53.4%）例接受了经耳道内窥镜耳手术（EES 3或TEES）。总体而言，五只耳朵 (13.2%) 出现复发，四只耳朵 (10.5%) 残留。胆脂瘤27耳，平均年龄10.9岁；先天性11耳，平均年龄3.8岁。获得性病例的手术时间较长（226 分钟 vs. 154 分钟）。两种胆脂瘤类型的听力结果相当。在三只（11.1%）后天耳朵和一只（9.1%）先天耳朵中发现残留疾病。总体而言，EES 3 例的复发率和残留病灶率最低，EES 2 例和 3 例耳的复发率和残留病灶率相对较低，包括 4 例 (12.9%) 复发和 2 例 (6.5%) 耳有残留病灶。结论内窥镜是切除小儿胆脂瘤的可行工具，并提供中耳和相关隐窝的良好可视化。证据水平 4。喉镜，127：2653-2658，2017
ObjectivesTo describe outcomes for endoscopic ear surgery (EES) for pediatric cholesteatoma at a tertiary pediatric hospital.MethodsRetrospective case series of 65 pediatric cholesteatoma cases in 38 ears. Subgrouping based on cholesteatoma type and EES type. Surgical findings, outcomes, and demographic data were evaluated.ResultsEndoscopes were used in 65 pediatric cholesteatoma cases in 38 primary ears (34 patients), followed for an average of 2.6 years (9 months to 4.6 years). The endoscope was used as the primary visualization tool in 31 (81.6%) ears (EES 2 or 3), and as an adjunct to the microscope in seven ears (EES 1). Twenty-two (57.9%) ears and 35 (53.4%) cases were transcanal endoscopic ear surgery (EES 3 or TEES). Overall, there was recurrence in five (13.2%) ears and residual in four (10.5%) ears. Cholesteatoma was acquired in 27 ears, with average age 10.9 years; and congenital in 11 ears, with average age 3.8 years. Surgical time was longer for acquired cases (226 vs. 154 minutes). Hearing outcomes were comparable for both cholesteatoma types. Residual disease was seen in three (11.1%) acquired ears and one (9.1%) congenital ear. Overall, the lowest rates of recurrent and residual disease were seen in EES 3 cases, and relatively low rates in EES 2 and 3 ears, including four (12.9%) recurrences and two (6.5%) ears with residual disease.ConclusionThe endoscopes are a viable tool for resection of pediatric cholesteatoma and provide excellent visualization of the middle ear and associated recesses.Level of Evidence4. Laryngoscope, 127:2653-2658, 2017