The combination of two-cavity surgery, endoscopic control and obliteration of the mastoid with bioactive glass for the primary operation of extensive cholesteatoma - initial results

Cholesteatoma surgery is afflicted with a not inconsiderable number of recurrences. The standard is the complete removal of the cholesteatoma under microscopic view with removal of the lateral attic wall and extensions for atticoantrotomy or mastoidectomy as a closed technique (with reconstruction of the posterior wall of the auditory canal) or as an open technique (with an open mastoid cavity). An alternative is the two-cavity surgery, where the mastoidal part of the cholesteatoma is approached transcortically and the tympanic part is addressed transmeatally. The problem here is the inner bone edge of the posterior wall of the auditory canal, which cannot be reliably checked microscopically and which leads to an increased number of recurrences. With the introduction of endoscopic technology in otology and new obliteration materials such as bioactive glass, the specific disadvantages of the two-cavity surgery can be compensated for. This is to be checked in a retrospective investigation of the first cases. Between 01/19 and 03/20, a total of 13 patients with extensive cholesteatomas were operated as described above. No recurrences were observed in the 12-month follow-up period, and the healing of the ears was significantly less problematic than would otherwise be expected from extensive ear operations. The postoperative hearing was in the range of the data that were collected for comparable operations.The main disadvantages of this intervention can be eliminated by extending the two-cavity surgery to include an endoscopic control and obliterating the mastoid cavity

Poster-PDF A-1341.pdf

Publication History

Article published online:
13 May 2021