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Updated: Jan 25, 2026

Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Non-microscopic Middle Ear Cholesteatoma Surgery: A Case Report of a Novel Head-Up Approach
1Middle Ear and Inner Ear Surgical Center, Japan Community Health Care Organization Kumamoto General Hospital, Kumamoto, Japan.
Objective:
To assess the feasibility of a postauricular transcortical mastoidectomy utilizing an exoscope, which offers 3D stereoscopic visualization.
Study Design:
Clinical capsule report.
Patients:
Two consecutive patients with cholesteatoma involvement in the mastoid cavity were included in the study.
Intervention:
After transcanal endoscopic surgery, postauricular mastoidectomy utilizing a surgical 3D exoscope was performed. Then, the cholesteatoma in the mastoid cavity was removed through the mastoidectomy opening with endoscopes.
Results:
The postauricular transcortical mastoidectomy utilizing a 3D exoscope was not only feasible, but importantly, the exoscope took little time to switch to and resulted in a smooth workflow. There was no cholesteatoma recurrence at 9 months.
Conclusion:
During endoscope-based surgery, in patients with cholesteatoma mastoid involvement, we can continue to perform the surgical procedure in a heads-up position utilizing a surgical 3D exoscope. The combination of transcanal endoscopic ear surgery and the postauricular transcortical mastoidectomy utilizing a surgical 3D exoscope is a very novel treatment strategy for cholesteatoma, and it gives us a comfortable and consistent working environment in endoscope-based ear surgery.
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