[Outcomes of ear endoscopic surgery for petrous bone cholesteatoma]

This study aimed to explore the surgical strategies and outcomes of petrosal bone cholesteatoma (PBC) surgery under ear endoscope. A retrospective analysis was conducted on the clinical data of PBC patients who underwent endoscopic surgery for PBC and were followed-up for≥1 year at West China Hospital, Sichuan University, from January 2017 to January 2024. The characteristics of the lesions, surgical procedures, and prognoses were evaluated. A total of seven patients were included, consisting of four males and three females, with 28-59 (36.4±11.0) years. According to the Sanna classification, four cases were classified as supralabyrinthine type and three as massive type, and all were managed with endoscopic resection. No facial nerve transposition was performed in any patient during surgery. Comparison of preoperative and postoperative facial nerve function based on the House-Brackman (HB) grading system showed that facial nerve function was preserved in five patients postoperatively; one patient was grade Ⅳ preoperatively and grade Ⅴ postoperatively, and one patient was grade Ⅵ preoperatively and remained grade Ⅵ postoperatively. Four patients had severe conductive or mixed hearing loss preoperatively, with the labyrinth preserved during surgery and one-stage ossicular reconstruction for hearing improvement; three patients had extreme sensorineural hearing loss preoperatively, with the labyrinth resected during surgery and no hearing reconstruction performed. Two patients experienced transient and minor cerebrospinal fluid otorrhea, which was resolved before discharge. All patients had dry ears within two months postoperatively, with one case of recurrence diagnosed at an external institution one year postoperatively. The endoscopic approach is feasible and appears beneficial in reducing trauma and recurrence rates in PBC surgery.