2015 Volume 36 Issue 3 Pages 356-362
The transition in operative procedures in 23 pediatric patients with congenital cholesteatoma (CC) who were primarily operated on in the five years before this study was investigated, and the surgical strategy for treatment of the disease is discussed.
Among operative procedures, microscopic endoscope-assisted ear surgery was primarily performed in most cases from 2009 to 2011. We selected transcanal tympanoplasty, transcanal atticotomy, or canal wall up tympanoplasty according to the extent of the cholesteatoma; however, no trend toward a particular surgical method was observed. On the other hand, the rate of transcanal endoscopic ear surgery (TEES) has been gradually increasing since 2013 and accounted for 80% of all surgeries in 2014. Early diagnosis of CC is now possible because of the development of diagnostic tools such as the high-vision endoscope attached to a monitor. Using Potsic's staging system to determine the CC stage, we categorized more than 50% of CC cases as Stage Ⅰ or Ⅱ. Therefore, the surgical procedure was limited to the tympanic cavity, and an increase in the proportion of en-bloc resections for cholesteatoma was observed. However, cases in which cholesteatoma extends to the attic or mastoid cavity require mastoidectomy with preservation of the posterior wall of the external ear canal. The surgical method should be selected in accordance with the status and extent of the cholesteatoma.
