Minimally invasive transcanal myringotomy for pediatric early stage congenital cholesteatoma

Int J Pediatr Otorhinolaryngol. 2016 Nov:90:1-4. doi: 10.1016/j.ijporl.2016.08.013. Epub 2016 Aug 24.

Abstract

Objective: Recently, minimally invasive transcanal myringotomy (MITM), which is a useful surgical technique for early stage congenital cholesteatoma (CC) in children, was introduced. The purpose of this study is to evaluate the short-term surgical results of MITM in pediatric early stage CC.

Materials and methods: We retrospectively reviewed the charts of 24 patients who underwent MITM between January 2013 and October 2015.

Results: The patients' ages ranged from 1 to 16 years (mean, 2.6 years). There were 17 male and 7 female patients. The right side (n = 13) was affected twice as often as the left side (n = 11). The most common site was the anterosuperior quadrant (15 cases). The diameter of the CC on axial computed tomography images ranged from 2.8 to 5.7 mm (mean, 3.9 mm). CCs were graded according to Potsic's system: 18 cases were classified as stage I, 3 case as stage II, and 3 cases as stage III. AllCCs except 1 were closed type. In21 patients, the tympanic membrane closed naturally without recurrence. Three patients showed small persistent dry perforation. Natural closure occurred in these patients, who were treated with paper patches.

Conclusion: MITM is a simple, effective technique for removing an early stage CC from the middle ear, and it can minimize operative time, length of hospitalization, and postoperative morbidity.

Keywords: Early congenital cholesteatoma; Minimally invasive; Myringotomy; Transcanal.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cholesteatoma / congenital*
  • Cholesteatoma / diagnostic imaging
  • Cholesteatoma / surgery
  • Cholesteatoma, Middle Ear / diagnostic imaging
  • Cholesteatoma, Middle Ear / surgery*
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Length of Stay
  • Male
  • Middle Ear Ventilation / methods*
  • Minimally Invasive Surgical Procedures
  • Operative Time
  • Otoscopy
  • Recurrence
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome

Supplementary concepts

  • Cholesteatoma, Congenital