Total Transcanal Endoscopic Ear Surgery for Cholesteatoma

OBJECTIVE: This study aimed to evaluate the outcomes of total transcanal endoscopic cholesteatoma surgery. METHODS: Twenty-seven cholesteatoma patients that had undergone transcanal endoscopic ear surgery (TEES) were included in the study. Age, sex, operation date of patients, operated side, need for ossiculoplasty, graft material, and surgical technique were recorded. All patients were evaluated through otoscopic, endoscopic, and audiological examinations and followed up for at least five months after surgery. All patients were staged using the European Academy of Otology and Neurotology/Japan Otological Society (EAONO/JOS) Staging System on Middle Ear Cholesteatoma. RESULTS: Mean age of the patients was 36.4 years (range, 4–67 years). According to the EAONO/JOS Staging System, 11 patients were stage 1, while 11 were stage 2, and five were stage 3. Two had lateral semicircular canal defect, one had facial canal dehiscence, and one had oval window defect. The average follow-up period was 19 months (range, 5–41 months), during which two patients experienced retraction pocket and hearing loss and one patient had perforation. One patient underwent revision surgery during follow-up and no recurrence or residual cholesteatoma was observed. The preoperative and postoperative air–bone gaps were 25.14±13.93 dB and 22.22±12.64 dB with no significant difference. CONCLUSION: TEES is a minimally invasive and safe procedure with low complication and recurrence rates. As with all surgical procedures, experience is essential, and as experience increases, the capability to perform endoscopic otologic surgery on more complex cases may become possible.