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A Novel Surgery Classification for Endoscopic Approaches to Middle Ear Cholesteatoma

查看全文 作  者:Yu [1]SUN;En-hao [1]WANG;Jin-tao [1]YU;Gang [1]ZHONG;Li-xin ZHU-Yi [1]WANG;Niu [1]XUN;Hong [1]YU;Wen [1]ZHOU;Zhen [1]XIE;Kun [1]ZHANG;Guo-run [1]FAN;Yi [1]ZHONG;Hong-jun [1]XIAO;Wei-jia [1]KONG 高影响力作者 机构地区:[1]Department of Otorhinolaryngology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China高影响力机构 出  处:《Current Medical Science》索引2020年第40卷第1期,共9页高影响力期刊 基  金:the Fundamental Research Funds for the Central Universities(No.2019kfyXKJC039). 摘  要:This study aimed to develop a novel surgery classification for an endoscopic approach to middle ear cholesteatoma.We retrospectively analyzed the surgical approaches and outcomes of patients with middle ear cholesteatoma.Middle ear cholesteatoma surgeries were divided into four types and two special types as follows:type I,attic retraction pocket,which only requires tympanostomy tube placement or retraction pocket resection and cartilage reconstruction;typeⅡ,cholesteatoma which is limited to the attic or in which endoscopy can confirm complete removal of mastoid cholesteatoma lesions,including type Ⅱa,requiring only use of a curette,and type Ⅱ b,requiring use of an electric drill or chisel;type Ⅲ,cholesteatoma not limited to the attic,in which endoscopy cannot confirm complete removal of mastoid cholesteatoma lesions,requiring the combined use of endoscope and microscope to perform endoscopic tympanoplasty and'Canal Wall Up'mastoidectomy;type Ⅳ,extensive involvement of mastoid cavity cholesteatoma lesions and/or cases with a potential risk of complications,removal of which can only be performed under a microscope for'Canal Wall Down'mastoidectomy.In addition,there were two special types:'difficult external auditory canal'and congenital cholesteatoma in children.In our system,type I and type U middle ear cholesteatoma surgery was completely performed under an endoscope alone.However,estimating the extent of the lesions,determining the choice of mastoid opening and reestablishing ventilation are the key points for an endoscopic approach to middle ear cholesteatoma.The classification of endoscopic middle ear cholesteatoma surgery may benefit the selection of surgical indications. 关 键 词:otologic surgical procedure ENDOSCOPY CHOLESTEATOMA middle ear
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