Related Experiment Video
Updated: Oct 3, 2025
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Comparison of endoscopic and microscopic management of attic cholesteatoma: A randomized controlled trial
Lihua Wu1, Qinghua Liu2, Bo Gao3
1Department of Otolaryngology, Fujian Medical University ShengLi Clinical College, Fujian Provincial Hospital, Fuzhou, China; Department of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China; Department of Otolaryngology, The First Affiliated Hospital of China Medical University, Shenyang, China.
Background:
Attic cholesteatoma is a common disease encountered by otologists.
Objectives:
To compare the endoscopic approach to attic cholesteatoma with conventional microscopic technique.
Material And Methods:
A total of 190 patients (192 ears) diagnosed with attic cholesteatoma extending to the antrum area (stages Ib and II) were randomly assigned into two groups undergoing endoscopic approach and the other microscopic technique. The outcomes were preoperative and intraoperative findings, access to hidden areas expressed in MESVI, mean operative time from first incision to ear-packing, and postoperative findings. Statistical analysis was performed by SPSS version 24.0, and P ≤ 0.05 was considered statistically significant.
Results:
The median Middle Ear Structural Visibility Index of the endoscopic group was better than the microscopic group (P < 0.05). The mean operating time by the endoscopic approach was less than the microscopic approach (P < 0.05). The median postoperative pain score in the endoscopic group was lower than the microscopic group (P < 0.05). In addition, there were no statistically significant differences in taste, hearing, vertigo, healing time and long term outcomes between the two groups.
Conclusion And Significance:
Endoscopic management of limited attic cholesteatoma showed definite advantages over the conventional microscopic approach, such as providing better visualization, requiring less postoperative time, subjecting the patients to less pain, and decreasing the incidence of complications.
