Pediatric Endoscopic Cholesteatoma Surgery.

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Medical Technology

Background:

• Cholesteatoma is a skin growth in the middle ear, often requiring surgical removal.
• Endoscopic techniques offer minimally invasive alternatives for ear surgery.

Purpose of the Study:

• To review a single center's experience with pediatric endoscopic cholesteatoma surgery.
• To compare surgical and audiologic outcomes of endoscopic versus microscopic cholesteatoma removal in children.
• To identify common locations of residual cholesteatoma after endoscopic removal.

Main Methods:

• A case series with chart review of pediatric patients (<19 years) undergoing cholesteatoma removal.
• Comparison of outcomes (residual disease, complications, audiometry) between total endoscopic ear surgery (TEES), combined endoscopic-microscopic surgery, and microscopic surgery.
• Analysis of 76 ears from 66 patients with an average follow-up of 18.8 months.

Main Results:

• Endoscopic cases required fewer mastoidectomies compared to microscopic cases (P = .049).
• While second-look procedures were more frequent in endoscopic cases (51.7% vs 21.3%, P = .006), residual disease rates were similar (20.0% vs 40.0%, P = .38).
• Total endoscopic ear surgery (TEES) showed significant improvement in air-bone gap (P = .009), with no reported complications.

Conclusions:

• Pediatric endoscopic cholesteatoma surgery demonstrates comparable hearing outcomes, recurrence rates, and complication profiles to traditional microscopic techniques.
• Endoscopic approaches are a viable and safe option for pediatric cholesteatoma management.
• Further research may explore the specific benefits of TEES for audiologic improvement.