Extension of indications for transcanal endoscopic ear surgery using an ultrasonic bone curette for cholesteatomas
- PMID: 24136323
- DOI: 10.1097/MAO.0b013e3182a446bc
Extension of indications for transcanal endoscopic ear surgery using an ultrasonic bone curette for cholesteatomas
Abstract
Background: One-handed endoscopic procedures have, up until now, limited the indications for transcanal endoscopic ear surgery (TEES) in cholesteatoma surgery. However, the development of electrically powered instruments has opened the door to such one-handed endoscopic procedures in restricted surgical spaces.
Objective: We examined the feasibility of using one such powered instrument, the ultrasonic bone curette (UBC) in TEES for cholesteatoma surgery. The UBC offers several advantages, including nonrotational motion and the combination of both suction and irrigation in a single handpiece.
Study design: A prospective case series.
Setting: Tertiary referral center.
Patients: TEES was performed on 43 cases of primary cholesteatoma between September 2011 and December 2012, including 14 cases extending to the antrum.
Intervention: Zero-, 30-, or 70-degree angled rigid endoscopes with an outer diameter of 2.7 mm (Karl Storz) were used together with a high-definition video system. A Sonopet UBC (Stryker) was used to cut bony tissue. The nonrotational motion of the UBC prevents injury to the tympanomeatal flap and other soft tissue, which may result with standard drills. Transcanal endoscopic retrograde mastoidectomy on demand was performed to access the pathologies in the attic and antrum.
Results: A minimum attico-antrotomy was performed using the UBC, removing only the bony tissue necessary to visualize the pathology. The cholesteatoma was completely removed from the antral mucosa under clear endoscopic visualization in 13 of 14 cases. After removal of the cholesteatoma, the canal wall was reconstructed using cartilage taken from the tragus. This procedure resulted in greater mastoid preservation.
Conclusion: The transcanal endoscopic approach to the antrum using the UBC proved to be less invasive and more functional. The UBC contains both a suction and irrigation system in a single handpiece, and this UBC is an appropriate cutting tool that extends the indications for TEES.
Similar articles
-
Safety of ultrasonic bone curette in ear surgery by measuring skull bone vibrations.Otol Neurotol. 2014 Apr;35(4):e135-9. doi: 10.1097/MAO.0000000000000209. Otol Neurotol. 2014. PMID: 24317210
-
Transcanal antrotomy.Laryngoscope. 2008 Nov;118(11):2036-9. doi: 10.1097/MLG.0b013e318182087f. Laryngoscope. 2008. PMID: 18818552
-
Non-EPI DW MRI in planning the surgical approach to primary and recurrent cholesteatoma.Otol Neurotol. 2014 Jan;35(1):121-5. doi: 10.1097/MAO.0000000000000234. Otol Neurotol. 2014. PMID: 24317217
-
Transcanal endoscopic management of cholesteatoma.Otolaryngol Clin North Am. 2013 Apr;46(2):107-30. doi: 10.1016/j.otc.2012.10.001. Epub 2012 Dec 20. Otolaryngol Clin North Am. 2013. PMID: 23566900 Review.
-
Techniques in Management of Cholesteatoma: Endoscopic Approaches.Otolaryngol Clin North Am. 2025 Feb;58(1):99-112. doi: 10.1016/j.otc.2024.08.007. Epub 2024 Oct 10. Otolaryngol Clin North Am. 2025. PMID: 39389827 Review.
Cited by
-
The effect of insulin-like growth factor 1 on the recovery of facial nerve function in a guinea pig model of facial palsy.J Physiol Sci. 2020 Jun 8;70(1):28. doi: 10.1186/s12576-020-00755-0. J Physiol Sci. 2020. PMID: 32513097 Free PMC article.
-
Localized Amyloidosis of the Nasal Mucosa: A Case Report and Review of the Literature.Front Surg. 2021 Nov 5;8:774469. doi: 10.3389/fsurg.2021.774469. eCollection 2021. Front Surg. 2021. PMID: 34805263 Free PMC article.
-
Endoscopic Inside-Out Mastoidectomy with the Ultrasonic Bone Aspirator.OTO Open. 2019 Jan 31;3(1):2473974X18821923. doi: 10.1177/2473974X18821923. eCollection 2019 Jan-Mar. OTO Open. 2019. PMID: 31236532 Free PMC article.
-
Inside-Out Transcanal Endoscopic Mastoidectomy: Literature Revision.Int Arch Otorhinolaryngol. 2023 Apr 28;27(2):e370-e376. doi: 10.1055/s-0043-1768202. eCollection 2023 Apr. Int Arch Otorhinolaryngol. 2023. PMID: 37125367 Free PMC article.
-
Retrograde mastoidectomy with canal wall reconstruction versus intact canal wall tympanomastoidectomy for cholesteatoma with minimal mastoid extension.Eur Arch Otorhinolaryngol. 2022 Nov;279(11):5113-5121. doi: 10.1007/s00405-022-07351-5. Epub 2022 Mar 29. Eur Arch Otorhinolaryngol. 2022. PMID: 35352144
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical