Endoscopic management of acquired cholesteatoma.

OBJECTIVE: This study aimed to describe and evaluate endoscopic technique for treatment of acquired cholesteatoma.

STUDY DESIGN: This study was a case series.

SETTINGS: The study was performed in a private otolaryngology practice.

PATIENTS: Thirty-eight adult patients with acquired cholesteatoma and no previous ear surgery composed the patient population.

INTERVENTION: Thirty-six patients underwent transcanal endoscopic tympanotomy and extended atticotomy with removal of the cholesteatoma sac; the attic defect was reconstructed in 25 patients and was packed open in 11 patients. Two patients underwent traditional postauricular procedures.

MAIN OUTCOME MEASURE: The main outcome measure was disease-free ears as evident on: 1) clinical examination at 1 year follow-up for 30 patients and at 2 years for 13 patients; and 2) surgical exploration in 6 patients at 2 years.

RESULTS: There were no significant complications associated with the 36 endoscopic procedures: 29 of 30 patients were disease free at 1 year, 10 of 13 were disease free on clinical examination at 2 years, and 4 of 6 were disease free on surgical exploration at 2 years.

CONCLUSIONS: Early results indicate that endoscopic removal of cholesteatoma offers a safe and effective transcanal alternative to postauricular procedures.