Advertisement

European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 5, pp 1069–1075 | Cite as

Endoscopic visualization to the anterior surface of the malleus and tensor tympani tendon in congenital cholesteatoma

  • Bong Jik Kim
  • Jung Ho Kim
  • Moo Kyun Park
  • Jun Ho Lee
  • Seung-ha Oh
  • Myung-Whan Suh
Otology

Abstract

Purpose

This study evaluated the feasibility of endoscopy in exposing the anterior surface of the malleus and tensor tympani tendon (ASMT) in children with congenital cholesteatoma (CC), and investigated the outcomes of hearing, postoperative complications, and residual or recurrent disease in endoscopic surgical approach cases.

Methods

A retrospective case review was performed in one tertiary referral center. Twelve children with CC involving the ASMT were recruited, and their medical records were reviewed. All patients underwent either total endoscopic surgery (n = 3) or endoscope-assisted surgery (n = 9), and Potsic staging was adopted to classify CC according to its severity: stage I (n = 8), stage II (n = 2), and stage III (n = 2). The mean follow-up period was 15.5 ± 2.8 months. The visibility of the ASMT by endoscope assistance, audiological results, surgical and postoperative complications, and recidivism of CC were analyzed.

Results

The ASMT was well visualized by endoscope assistance in all cases. No patient showed hearing deterioration at 3 months after surgery, and none experienced residual or recurrent disease during the follow-up period. Postoperative complications were not observed.

Conclusions

Total endoscopic or endoscope-assisted surgery could help surgeons directly visualize the ASMT in children, with negligible risks of hearing deterioration, postoperative complications, and recurrent disease. Our study might suggest that endoscopic ear surgery should be considered in patients with CC in the ASMT.

Keywords

Congenital cholesteatoma Endoscope Malleus Tensor tympani tendon Potsic staging 

Notes

Funding

This study was supported by the National Research Foundation of Korea grant funded by the Korea government (no. NRF-2017R1C1B3005431).

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Approval of the Institutional Review Board at the hospital was obtained for this retrospective study (SNUH 2016-3449).

Supplementary material

405_2018_4917_MOESM1_ESM.tif (6.9 mb)
Supplementary Figure 1. Representative pathology images of CC with or without inflammatory cells. Keratin materials without inflammatory cells comprising CC (A) and CC showing inflammatory cells (predominantly lymphocytes) (B). (TIF 7103 KB)
405_2018_4917_MOESM2_ESM.docx (15 kb)
Supplementary material 2 (DOCX 14 KB)

References

  1. 1.
    Levenson MJ, Parisier SC, Chute P, Wenig S, Juarbe C (1986) A review of twenty congenital cholesteatomas of the middle ear in children. Otolaryngol Head Neck Surg 94(5):560–567.  https://doi.org/10.1177/019459988609400505 CrossRefPubMedGoogle Scholar
  2. 2.
    Nelson M, Roger G, Koltai PJ, Garabedian EN, Triglia JM, Roman S, Castellon RJ, Hammel JP (2002) Congenital cholesteatoma: classification, management, and outcome. Arch Otolaryngol Head Neck Surg 128(7):810–814CrossRefPubMedGoogle Scholar
  3. 3.
    James AL, Papsin BC (2013) Some considerations in congenital cholesteatoma. Curr Opin Otolaryngol Head Neck Surg 21(5):431–439.  https://doi.org/10.1097/MOO.0b013e328364b457 CrossRefPubMedGoogle Scholar
  4. 4.
    Tarabichi M (2004) Endoscopic management of limited attic cholesteatoma. Laryngoscope 114(7):1157–1162.  https://doi.org/10.1097/00005537-200407000-00005 CrossRefPubMedGoogle Scholar
  5. 5.
    Presutti L, Marchioni D, Mattioli F, Villari D, Alicandri-Ciufelli M (2008) Endoscopic management of acquired cholesteatoma: our experience. J Otolaryngol Head Neck Surg 37(4):481–487PubMedGoogle Scholar
  6. 6.
    Marchioni D, Soloperto D, Rubini A, Villari D, Genovese E, Artioli F, Presutti L (2015) Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: our experience. Int J Pediatr Otorhinolaryngol 79(3):316–322.  https://doi.org/10.1016/j.ijporl.2014.12.008 CrossRefPubMedGoogle Scholar
  7. 7.
    Marchioni D, Mattioli F, Alicandri-Ciufelli M, Presutti L (2009) Transcanal endoscopic approach to the sinus tympani: a clinical report. Otol Neurotol 30(6):758–765.  https://doi.org/10.1097/MAO.0b013e3181b0503e CrossRefPubMedGoogle Scholar
  8. 8.
    Magliulo G, Iannella G (2017) Endoscopic versus microscopic approach in attic cholesteatoma surgery. Am J Otolaryngol.  https://doi.org/10.1016/j.amjoto.2017.10.003 Google Scholar
  9. 9.
    Potsic WP, Samadi DS, Marsh RR, Wetmore RF (2002) A staging system for congenital cholesteatoma. Arch Otolaryngol Head Neck Surg 128(9):1009–1012CrossRefPubMedGoogle Scholar
  10. 10.
    Koltai PJ, Nelson M, Castellon RJ, Garabedian EN, Triglia JM, Roman S, Roger G (2002) The natural history of congenital cholesteatoma. Arch Otolaryngol Head Neck Surg 128(7):804–809CrossRefPubMedGoogle Scholar
  11. 11.
    Potsic WP, Korman SB, Samadi DS, Wetmore RF (2002) Congenital cholesteatoma: 20 years’ experience at The Children’s Hospital of Philadelphia. Otolaryngol Head Neck Surg 126(4):409–414CrossRefPubMedGoogle Scholar
  12. 12.
    Jang CH, Cho YB (2008) Congenital cholesteatoma extending into the internal auditory canal and cochlea: a case report. In Vivo 22(5):651–654PubMedGoogle Scholar
  13. 13.
    Marchioni D, Mattioli F, Alicandri-Ciufelli M, Presutti L (2009) Endoscopic approach to tensor fold in patients with attic cholesteatoma. Acta Otolaryngol 129(9):946–954.  https://doi.org/10.1080/00016480802468187 CrossRefPubMedGoogle Scholar
  14. 14.
    James AL (2013) Endoscopic middle ear surgery in children. Otolaryngol Clin North Am 46(2):233–244.  https://doi.org/10.1016/j.otc.2012.10.007 CrossRefPubMedGoogle Scholar
  15. 15.
    Hamilton JW (2005) Efficacy of the KTP laser in the treatment of middle ear cholesteatoma. Otol Neurotol 26(2):135–139CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Bong Jik Kim
    • 1
    • 2
  • Jung Ho Kim
    • 3
  • Moo Kyun Park
    • 1
  • Jun Ho Lee
    • 1
  • Seung-ha Oh
    • 1
  • Myung-Whan Suh
    • 1
  1. 1.Department of Otorhinolaryngology-Head and Neck SurgerySeoul National University HospitalSeoulRepublic of Korea
  2. 2.Department of Otolaryngology-Head and Neck Surgery, College of MedicineChungnam National UniversityDaejeonRepublic of Korea
  3. 3.Department of PathologySeoul National University HospitalSeoulRepublic of Korea

Personalised recommendations