Transcanal endoscopic management of cholesteatoma.

OBJECTIVE To assess the advantages and disadvantages of using endoscopic technique in the management of cholesteatoma. STUDY DESIGN Retrospective case review. SETTING Private otology practice. PATIENTS Patients with cholesteatoma of the temporal bone presenting over a 16-year period to a single otologist. INTERVENTION(S) Primary endoscopic surgery for removal of the cholesteatoma and further reconstruction and monitoring of patients. MAIN OUTCOME MEASURE(S) Clinical evidence of recurrent cholesteatoma. RESULTS One hundred sixty-eight ear procedures performed for cholesteatoma using 2 primary techniques. Average follow-up was 35 months. Twelve recurrences were evident. CONCLUSION Endoscopic management of cholesteatoma allows the use of the ear canal as the direct and natural access point to cholesteatoma within the mesotympanum, attic, facial recess, sinus tympani, hypotympanum, and eustachian tube. It does not improve access to mastoid disease.