Study of the Role of Otoendoscope in Detecting Residual Disease in Cholesteatoma Surgery

Introduction: Residual cholesteatoma occurs due to incomplete removal after primary surgery by microscope and is frequently caused by inaccessible locations such as the sinus tympani. The use of the surgical endoscope brought advances in the surgical management of cholesteatoma. Aim: This work aims to assess microscope-assisted otoendoscopy in cholesteatoma surgical management. Patients and Methods: Forty patients underwent ear surgery for a cholesteatoma using different canal wall up or canal wall down mastoidectomy techniques. Surgery was initially performed using a surgical microscope. After complete disease excision microscopically, the middle ear and mastoid cavities were examined by otovideoendoscopy, especially sinus tympani, facial recess, anterior epitympanic recess, Eustachian tube, and hypotympanum. Residual cholesteatoma was identified, and its location was reported. Results: Residual cholesteatoma was found by endoscope in 10 sites; 6, 3, and 1 in sinus tympani, anterior epitympanic recess, and facial recess, respectively. These ten sites were divided into 4 in modified radical mastoidectomy and 6 in conservative approaches. Conclusion: Endoscopic-assisted ear surgery had much-increased benefits in cholesteatoma surgery. Endoscope had become a crucial complement to the operating microscope through visualizing the middle ear cleft hidden areas and discovering any residual disease in such areas as the sinus tympani..