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A Novel Surgery Classification for Endoscopic Approaches to Middle Ear Cholesteatoma

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Summary

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; type II, cholesteatoma which is limited to the attic or in which endoscopy can confirm complete removal of mastoid cholesteatoma lesions, including type II a, 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 II 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.

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Author notes

  1. These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Yu Sun, En-hao Wang, Jin-tao Yu, Gang Zhong, Li-xin Zhu, Yi Wang, Niu Xun, Hong Yu, Wen Zhou, Zhen Xie, Kun Zhang, Guo-run Fan, Yi Zhong, Hong-jun Xiao & Wei-jia Kong

Authors
  1. Yu Sun
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  2. En-hao Wang
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  3. Jin-tao Yu
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  4. Gang Zhong
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  5. Li-xin Zhu
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  6. Yi Wang
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  7. Niu Xun
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  8. Hong Yu
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  9. Wen Zhou
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  10. Zhen Xie
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  11. Kun Zhang
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  12. Guo-run Fan
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  13. Yi Zhong
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  14. Hong-jun Xiao
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  15. Wei-jia Kong
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Corresponding authors

Correspondence to Yu Sun, Hong-jun Xiao or Wei-jia Kong.

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Conflict of Interest Statement

The authors have no conflict of interest.

This work was supported by the Fundamental Research Funds for the Central Universities (No. 2019kfyXKJC039).

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Sun, Y., Wang, Eh., Yu, Jt. et al. A Novel Surgery Classification for Endoscopic Approaches to Middle Ear Cholesteatoma. CURR MED SCI 40, 9–17 (2020). https://doi.org/10.1007/s11596-020-2141-0

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  • DOI: https://doi.org/10.1007/s11596-020-2141-0

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