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. 2014 Jun;34(3):153-7.

Results of endoscopic middle ear surgery for cholesteatoma treatment: a systematic review

L Presutti  1 , F M Gioacchini  1 , M Alicandri-Ciufelli  1 , D Villari  1 , D Marchioni  1
Affiliations

Results of endoscopic middle ear surgery for cholesteatoma treatment: a systematic review

L Presutti et al. Acta Otorhinolaryngol Ital. 2014 Jun.

Abstract
in English, Italian

Traditional surgery for cholesteatoma of the middle ear is performed by microscopic approaches. However, in recent years endoscopic instrumentation, techniques and knowledge have greatly improved, and in our opinion endoscopic surgical techniques will gain increasing importance in otologic surgery in the future. The aim of this study was to focus on outcomes obtained using endoscopic surgery for the treatment of middle ear cholesteatoma. A systematic review of the literature was performed. A total of 7 articles comprising 515 patients treated exclusively with endoscope or with a combined technique were found. During post-surgical follow-up, 48 (9.3%) patients showed a residual or recurrent pathology. Despite the small number of patients analyzed in our review, the outcomes of this technique appear to be promising. In particular, concerning the rates of recurrences and residual disease, endoscopic middle ear surgery appears to guarantee similar results in comparison to classic microscopic approaches with the advantage of performing minimally invasive surgery.

La chirurgia tradizionale per il colesteatoma dell'orecchio medio è praticata mediante approcci microscopici. Comunque durante gli anni più recenti la strumentazione endoscopica, le tecniche, e la coscienza sono nettamente migliorate, e secondo il nostro parere in futuro, le tecniche di chirurgia endoscopica acquisiranno importanza nella otochirurgia. L'obiettivo di questo studio è stato quello di focalizzare i risultati ottenuti mediante l'uso della chirurgia endoscopica nel trattamento del colesteatoma dell'orecchio medio. È stata eseguita una revisione sistematica della letteratura. Sono stati trovati un totale di sette articoli che comprendevano 515 pazienti trattati esclusivamente con l'endoscopio o con una tecnica combinata. Complessivamente durante il follow-up post chirurgico, 48 (9,3%) pazienti hanno mostrato una recidiva o un residuo di malattia. Nonostante il piccolo numero di pazienti analizzati nella nostra revisione, i risultati di questa tecnica sembrano essere promettenti. In particolare, riguardo alle percentuali di recidive e residui di malattia, la chirurgia endoscopica dell'orecchio medio sembra garantire risultati simili a confronto di quelli ottenuti con i classici approcci microscopici avendo però anche il grande vantaggio di poter eseguire una chirurgia mini invasiva.

Keywords: Cholesteatoma; Endoscopic ear surgery; Recurrence; Residual.

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