Efficacy of Otoendoscopy for Residual Cholesteatoma Detection During Microscopic Chronic Ear Surgery
BACKGROUND: The aim of this article is to determine the efficacy of otoendoscopy during microscopic cholesteatoma surgery on residual cholesteatoma rates postoperatively. METHODS: The medical records of patients (aged 4-90) with primary acquired cholesteatoma who underwent microscopic cholesteato...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
AVES
2024-05-01
|
| Series: | Journal of International Advanced Otology |
| Online Access: | https://www.advancedotology.org/en/efficacy-of-otoendoscopy-for-residual-cholesteatoma-detection-during-microscopic-chronic-ear-surgery-131922 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846096725697101824 |
|---|---|
| author | Floor Couvreur Elke Loos Christian Desloovere Nicolas Verhaert |
| author_facet | Floor Couvreur Elke Loos Christian Desloovere Nicolas Verhaert |
| author_sort | Floor Couvreur |
| collection | DOAJ |
| description | BACKGROUND: The aim of this article is to determine the efficacy of otoendoscopy during microscopic cholesteatoma surgery on residual cholesteatoma rates postoperatively.
METHODS: The medical records of patients (aged 4-90) with primary acquired cholesteatoma who underwent microscopic cholesteatoma surgery (exclusively transcanal approach or canal wall-up tympano-mastoidectomy) with subsequent otoendoscopic examination (80 ears) for intraoperative cholesteatoma residues were retrospectively reviewed. All cases with mixed microscopic/endoscopic, fully endoscopic, or fully microscopic dissection were excluded, as well as cases where a canal wall-down technique was used. After microscopic cholesteatoma removal, the otoendoscope was used to inspect the middle ear recesses for intraoperative cholesteatoma residues. The intra- and postoperative cholesteatoma residue rate were evaluated.
RESULTS: On endoscopic examination, intraoperative cholesteatoma residues were encountered in 24 patients (30%). A total of 30 foci were detected. Most of them were found in the superior retrotympanum (15 foci). In 9 cases an antral remnant guided the surgeon to convert to a canal wall up tympanomastoidectomy. During the postoperative follow-up period, residual cholesteatoma was detected on postoperative magnetic resonance imaging in 6 patients (7.5%). Adding an otoendoscopic examination to microscopic cholesteatoma surgery reduced the postoperative cholesteatoma residues rate (odds ratio=0.16). A negative otoendoscopic examination led to a cholesteatoma residue-free follow-up period in 95% of cases(NPV=0.95).
CONCLUSION: Otoendoscopy is effective in identifying intraoperative cholesteatoma residues after microscopic cholesteatoma surgery. It reduces the postoperative cholesteatoma residue rate, and a negative otoendoscopic examination increases the likelihood of a cholesteatoma residue-free follow-up. |
| format | Article |
| id | doaj-art-da4d6f1a25f449908b5e50e6f364cd37 |
| institution | Kabale University |
| issn | 2148-3817 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | AVES |
| record_format | Article |
| series | Journal of International Advanced Otology |
| spelling | doaj-art-da4d6f1a25f449908b5e50e6f364cd372025-01-02T06:05:45ZengAVESJournal of International Advanced Otology2148-38172024-05-0120322523010.5152/iao.2024.231122Efficacy of Otoendoscopy for Residual Cholesteatoma Detection During Microscopic Chronic Ear SurgeryFloor Couvreur0Elke Loos1Christian Desloovere2Nicolas Verhaert3Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, Leuven, BelgiumDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium ; Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology, Leuven, BelgiumDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium ; Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology, Leuven, BelgiumDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium ; Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology, Leuven, BelgiumBACKGROUND: The aim of this article is to determine the efficacy of otoendoscopy during microscopic cholesteatoma surgery on residual cholesteatoma rates postoperatively. METHODS: The medical records of patients (aged 4-90) with primary acquired cholesteatoma who underwent microscopic cholesteatoma surgery (exclusively transcanal approach or canal wall-up tympano-mastoidectomy) with subsequent otoendoscopic examination (80 ears) for intraoperative cholesteatoma residues were retrospectively reviewed. All cases with mixed microscopic/endoscopic, fully endoscopic, or fully microscopic dissection were excluded, as well as cases where a canal wall-down technique was used. After microscopic cholesteatoma removal, the otoendoscope was used to inspect the middle ear recesses for intraoperative cholesteatoma residues. The intra- and postoperative cholesteatoma residue rate were evaluated. RESULTS: On endoscopic examination, intraoperative cholesteatoma residues were encountered in 24 patients (30%). A total of 30 foci were detected. Most of them were found in the superior retrotympanum (15 foci). In 9 cases an antral remnant guided the surgeon to convert to a canal wall up tympanomastoidectomy. During the postoperative follow-up period, residual cholesteatoma was detected on postoperative magnetic resonance imaging in 6 patients (7.5%). Adding an otoendoscopic examination to microscopic cholesteatoma surgery reduced the postoperative cholesteatoma residues rate (odds ratio=0.16). A negative otoendoscopic examination led to a cholesteatoma residue-free follow-up period in 95% of cases(NPV=0.95). CONCLUSION: Otoendoscopy is effective in identifying intraoperative cholesteatoma residues after microscopic cholesteatoma surgery. It reduces the postoperative cholesteatoma residue rate, and a negative otoendoscopic examination increases the likelihood of a cholesteatoma residue-free follow-up.https://www.advancedotology.org/en/efficacy-of-otoendoscopy-for-residual-cholesteatoma-detection-during-microscopic-chronic-ear-surgery-131922 |
| spellingShingle | Floor Couvreur Elke Loos Christian Desloovere Nicolas Verhaert Efficacy of Otoendoscopy for Residual Cholesteatoma Detection During Microscopic Chronic Ear Surgery Journal of International Advanced Otology |
| title | Efficacy of Otoendoscopy for Residual Cholesteatoma Detection During Microscopic Chronic Ear Surgery |
| title_full | Efficacy of Otoendoscopy for Residual Cholesteatoma Detection During Microscopic Chronic Ear Surgery |
| title_fullStr | Efficacy of Otoendoscopy for Residual Cholesteatoma Detection During Microscopic Chronic Ear Surgery |
| title_full_unstemmed | Efficacy of Otoendoscopy for Residual Cholesteatoma Detection During Microscopic Chronic Ear Surgery |
| title_short | Efficacy of Otoendoscopy for Residual Cholesteatoma Detection During Microscopic Chronic Ear Surgery |
| title_sort | efficacy of otoendoscopy for residual cholesteatoma detection during microscopic chronic ear surgery |
| url | https://www.advancedotology.org/en/efficacy-of-otoendoscopy-for-residual-cholesteatoma-detection-during-microscopic-chronic-ear-surgery-131922 |
| work_keys_str_mv | AT floorcouvreur efficacyofotoendoscopyforresidualcholesteatomadetectionduringmicroscopicchronicearsurgery AT elkeloos efficacyofotoendoscopyforresidualcholesteatomadetectionduringmicroscopicchronicearsurgery AT christiandesloovere efficacyofotoendoscopyforresidualcholesteatomadetectionduringmicroscopicchronicearsurgery AT nicolasverhaert efficacyofotoendoscopyforresidualcholesteatomadetectionduringmicroscopicchronicearsurgery |