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Endoscopic transcanal attico-antrostomy versus endoscopic-assisted canal wall up mastoidectomy in management of localized cholesteatoma: a randomized clinical trial

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objectives

This study aims to compare results of endoscopic transcanal tympanoplasty with attico-antrostomy with endoscopic-assisted canal wall up mastoidectomy in treatment of cases of limited attic cholesteatoma.

Materials and methods

A prospective randomized single-blinded study involving 40 patients with limited attic cholesteatoma was conducted. Randomization of the patients into two groups was done; 20 patients are managed by endoscopic transcanal tympanoplasty with attico-antrostomy, while the other 20 patients are managed by endoscopic-assisted canal wall up mastoidectomy. Primary outcome is recidivism, while secondary outcomes include hearing results, operative time, pain score and associated complications.

Results

Comparable recidivism rate was found in the two groups. The endoscopic-assisted canal wall up mastoidectomy group was associated with significantly longer duration of surgery and higher postoperative pain score. There was no significant difference between both the groups regarding hearing results and associated complications.

Conclusion

In localized attic cholesteatoma cases, endoscopic transcanal tympanoplasty with attico-antrostomy is a time-saving less-invasive reliable technique with good eradication results.

Clinical trial registry

ClinicalTrials.gov (NCT04959539) “retrospectively registered” at 12/7/2021.

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Funding

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, Mansoura University, El-Gomhoria Street, Mansoura, Dakahlia Governorate, Egypt

    Waleed Moneir, Ahmed Hemdan, Noha Ahmed El-Kholy, Mohamed El-Kotb & Mohamed El-Okda

Authors
  1. Waleed Moneir
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  2. Ahmed Hemdan
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  3. Noha Ahmed El-Kholy
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  4. Mohamed El-Kotb
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  5. Mohamed El-Okda
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Contributions

WM: conception and design of the study, performing the surgical intervention, interpretation of data, revising and final approval of manuscript. AH: design of the study, analysis and interpretation of data, revising and final approval of manuscript. NAE-K: analysis, interpretation of data, drafting, revising and final approval of manuscript. ME-K: design and supervision of the study, interpretation of data, revising and final approval of manuscript. ME-O: design and supervision of the study, interpretation of data, revising and final approval of manuscript.

Corresponding author

Correspondence to Noha Ahmed El-Kholy.

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Conflict of interests

None to declare.

Ethical approval

Approval of institutional review board of Mansoura University, Faculty of Medicine (MS/17.05.161) was obtained. Consolidated Standards of Reporting Trials (CONSORT) statement was adhered to with registration at the Clinical Trials Registry (NCT04959539).

Consent

All the patients signed a written informed consent prior to surgery.

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Moneir, W., Hemdan, A., El-Kholy, N.A. et al. Endoscopic transcanal attico-antrostomy versus endoscopic-assisted canal wall up mastoidectomy in management of localized cholesteatoma: a randomized clinical trial. Eur Arch Otorhinolaryngol 279, 4371–4378 (2022). https://doi.org/10.1007/s00405-021-07200-x

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  • DOI: https://doi.org/10.1007/s00405-021-07200-x

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