Endoscopic Otosurgery for Congenital Cholesteatoma in Children

Endoscope is very useful for otosurgery of congenital cholesteatoma in children, because endoscopic observation can give a full view to find residual cholesteatoma in the tympanic sinus or behind the ossicles or to avoid any injury of the important structures. In the middle ear, there is a region where microscopic observation is very difficult due to the anatomical feature. It is very dangerous to perform otosurgery without adequate observation of these structures. We experienced 7 children with congenital cholesteatoma in the past 6 years and obtained good results. We reported a case of the youngest one that was the most difficult to inspect througout the middle ear cavity . Disadvantage of endoscope was that otosurgeon has to hold an endoscope with the left hand and handle forceps or suction tube with the right. It might be difficult to handle endoscope and surgical tools together in the narrow external canal. We think that otosurgeon needs some experience for endoscopic operation. Our conclusion was that endoscope should be used in otosurgery of cholsteatoma in children to perform safe operation with a full view of the middle ear cavity and to avoid to overlook the residual lesions .