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Updated: Sep 22, 2025
Robot-Assisted Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma
Published on: December 15, 2023
Endoscopic Ear Surgery for Congenital Cholesteatoma in Children
Yeonjoo Choi1, Min Young Kwak2, Woo Seok Kang1
1Department of Otorhinolaryngology - Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
Insights
Endoscopic ear surgery is a safe and effective alternative for pediatric congenital cholesteatoma removal, showing comparable outcomes to traditional microscopic methods. This approach offers excellent visualization and middle ear access for improved surgical results.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Congenital cholesteatoma in children requires effective surgical removal.
- Endoscopic ear surgery offers enhanced visualization of the middle ear.
- This study compares endoscopic vs. microscopic approaches for pediatric cholesteatoma.
Purpose of the Study:
- To compare the efficacy and safety of endoscopic ear surgery versus microscopic surgery for congenital cholesteatoma in children.
- To evaluate operative time, hospital stay, complications, and recurrence rates between the two surgical techniques.
Main Methods:
- Retrospective review of pediatric patients (<8 years) with middle ear congenital cholesteatoma (Jan 2013-Dec 2018).
- Comparison of outcomes between microscopic surgery (n=12) and endoscopic surgery (n=21).
- Outcomes assessed included operative time, hospital stay, complications, recurrence, and tympanic membrane integrity.
Main Results:
- No significant difference in operative time or hospital stay between endoscopic and microscopic groups.
- No postoperative sensorineural hearing loss or major complications reported in either group.
- Similar recurrence/residue rates (4 cases total) and tympanic membrane integrity (90.5-94.7% intact) observed in both groups.
Conclusions:
- Endoscopic ear surgery is a safe and effective method for removing pediatric congenital cholesteatoma.
- Endoscopic approach is not inferior to conventional microscopic surgery for this condition.
- Both techniques result in comparable outcomes regarding complications, recurrence, and tympanic membrane status.
Background:
Endoscopic ear surgery is a promising technique for removing congenital cholesteatoma in children. It can provide greater visual access to hidden areas of the middle ear and facilitate middle-ear manipulation. This study compares a single-center experience in manag- ing congenital cholesteatoma with an endoscopic approach with that in managing congenital cholesteatoma with a conventional microscopic approach.
Methods:
Records of consecutive patients aged under 8 with congenital cholesteatoma confined to the middle ear at our tertiary referral hospital from January 2013 to December 2018 were retrospectively reviewed. Operation time, hospital stay, postoperative complications, and recurrence/residue of congenital cholesteatoma were compared between patients receiving microscopic versus endoscopic surgery.
Results:
A total of 33 pediatric patients aged from 19 months to 7 years were enrolled; 12 children underwent microscopic surgery, and 21 received an endoscopic approach for removing congenital cholesteatoma. The mean operative time was 1.61 hours for the microscopic group and 1.49 hours for the endoscopic group without statistical difference. No postoperative sensorineural hearing loss and complications were reported. Four cases of recurrence/residue were observed on the follow-up endoscopic exam or computed tomography, and no differences were shown between the 2 groups. Of the total patients, 94.7% (n=11) in the microscopic group and 90.5% (n=19) in the endoscopic group demonstrated an intact tympanic membrane without perforation or retraction after surgery. No audiological differences were reported between the 2 groups.
Conclusion:
Endoscopic ear surgery can effectively and safely remove congenital cholesteatoma in children and is not inferior to conventional microscopic approaches.
