Download PDF
CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2023; 27(02): e370-e376
DOI: 10.1055/s-0043-1768202
Systematic Reviews

Inside-Out Transcanal Endoscopic Mastoidectomy: Literature Revision

Renan Gonçalves Bessa 
1   Department of Otorhinolaryngology, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil
,
Robinson Koji Tsuji 
1   Department of Otorhinolaryngology, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Introduction Recently, there have been significant advancements in transcanal endoscopic ear surgery (TEES). The combination of rigid and thin otoendoscopes with high-definition cameras enabled a less invasive transcanal access to the middle ear and a clearer view of the surgical field. Several surgeons have recently published studies about cholesteatoma resection via transcanal endoscopic surgery, even in cases where the disease has extended to the mastoid, requiring transcanal endoscopic mastoidectomy.

Objectives To analyze the currently available literature on transcanal endoscopic inside-out mastoidectomy, and to determine its efficacy as a surgical technique by evaluating the disease's relapse/recurrence rate.

Data Synthesis Initially, the titles and abstracts of articles identified were analyzed. At this stage, 117 articles were analyzed, 97 of which were excluded for not meeting the inclusion criteria. The 20 remaining articles were further evaluated. The articles were classified on the basis of five levels of scientific evidence.

Final Comments The analysis of the studies showed that the transcanal endoscopic approach is effective in providing access to the attic or antrum, especially in cases of sclerotic mastoids. There was only one study with grade A recommendation, which showed the efficacy of endoscopic ear surgery in the treatment of cholesteatoma. Furthermore, there were three studies with grade B recommendation, showing less relapse/recurrence after TEES. More studies with grade A and B recommendations are needed to better evaluate the effectiveness of TEES, especially compared with that of traditional microscopic surgery.

Keywords

grade - endoscopic - recommendation - cholesteatoma - otology - neurotology


Publication History

Received: 01 September 2021

Accepted: 27 October 2021

Article published online:
28 April 2023

© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Imai T, Nishiike S, Oshima K, Tanaka H, Tsuruta Y, Tomiyama Y. The resected area of the posterior wall of the external auditory canal during transcanal endoscopic ear surgery for cholesteatoma. Auris Nasus Larynx 2017; 44 (02) 141-146 DOI: 10.1016/j.anl.2016.06.003.
    CrossrefPubMedGoogle Scholar
  • 2 Kakehata S, Watanabe T, Ito T, Kubota T, Furukawa T. Extension of indications for transcanal endoscopic ear surgery using an ultrasonic bone curette for cholesteatomas. Otol Neurotol 2014; 35 (01) 101-107
    CrossrefPubMedGoogle Scholar
  • 3 Nishiike S, Oshima K, Imai T, Uetsuka S. A novel endoscopic hydro-mastoidectomy technique for transcanal endoscopic ear surgery. J Laryngol Otol 2019; 133 (03) 248-250
    CrossrefPubMedGoogle Scholar
  • 4 Alicandri-Ciufelli M, Marchioni D, Kakehata S, Presutti L, Villari D. Endoscopic Management of Attic Cholesteatoma: Long-Term Results. Otolaryngol Clin North Am 2016; 49 (05) 1265-1270
    CrossrefPubMedGoogle Scholar
  • 5 Bae MR, Kang WS, Chung JW. Comparison of the clinical results of attic cholesteatoma treatment: Endoscopic versus microscopic ear surgery. Clin Exp Otorhinolaryngol 2019; 12 (02) 156-162
    CrossrefPubMedGoogle Scholar
  • 6 Das A, Mitra S, Ghosh D, Sengupta A. Endoscopic Versus Microscopic Management of Attic Cholesteatoma: A Randomized Controlled Trial. Laryngoscope 2020; 130 (10) 2461-2466
    CrossrefPubMedGoogle Scholar
  • 7 Gardner EG, Sappington J, Arriaga MA, Kanotra SP. Ultrasonic bone aspirator use in endoscopic ear surgery: feasibility and safety assessed using cadaveric temporal bones. J Laryngol Otol 2017; 131 (11) 987-990
    CrossrefPubMedGoogle Scholar
  • 8 Glikson E, Feinmesser G, Sagiv D, Wolf M, Migirov L, Shapira Y. Trans-canal endoscopic ear surgery and canal wall-up tympano-mastoidectomy for pediatric middle ear cholesteatoma. Eur Arch Otorhinolaryngol 2019; 276 (11) 3021-3026 DOI: 10.1007/s00405-019-05588-1.
    CrossrefPubMedGoogle Scholar
  • 9 Holt JJ. Transcanal antrotomy. Laryngoscope 2008; 118 (11) 2036-2039
    CrossrefPubMedGoogle Scholar
  • 10 Killeen DE, Tolisano AM, Kou YF, Kutz Jr JW, Isaacson B. Recidivism After Endoscopic Treatment of Cholesteatoma. Otol Neurotol 2019; 40 (10) 1313-1321
    CrossrefPubMedGoogle Scholar
  • 11 Marchioni D, Villari D, Alicandri-Ciufelli M, Piccinini A, Presutti L. Endoscopic open technique in patients with middle ear cholesteatoma. Eur Arch Otorhinolaryngol 2011; 268 (11) 1557-1563
    CrossrefPubMedGoogle Scholar
  • 12 Migirov L, Shapira Y, Horowitz Z, Wolf M. Exclusive endoscopic ear surgery for acquired cholesteatoma: preliminary results. Otol Neurotol 2011; 32 (03) 433-436
    CrossrefPubMedGoogle Scholar
  • 13 Presutti L, Anschuetz L, Rubini A. et al. The Impact of the Transcanal Endoscopic Approach and Mastoid Preservation on Recurrence of Primary Acquired Attic Cholesteatoma. Otol Neurotol 2018; 39 (04) 445-450
    CrossrefPubMedGoogle Scholar
  • 14 Tarabichi M. Endoscopic management of cholesteatoma: long-term results. Otolaryngol Head Neck Surg 2000; 122 (06) 874-881
    PubMedGoogle Scholar
  • 15 Tarabichi M. Transcanal endoscopic management of cholesteatoma. Otol Neurotol 2010; 31 (04) 580-588 DOI: 10.1097/MAO.0b013e3181db72f8.
    CrossrefPubMedGoogle Scholar
  • 16 Tolisano AM, Killeen DE, Hunter JB, Kutz Jr JW, Isaacson B. The Antrum-Malleus-Tegmen Score: A Pilot Study Assessing Preoperative Radiographic Predictors for Transcanal Endoscopic Cholesteatoma Dissection. Otol Neurotol 2019; 40 (09) e901-e908
    CrossrefPubMedGoogle Scholar
  • 17 Wu N, Wang F, Hou Z, Yang S. Improvement of otoendoscopic surgery for epitympanic cholesteatoma invading the mastoid. Acta Otolaryngol 2019; 139 (06) 492-496 DOI: 10.1080/00016489.2019.1597985.
    CrossrefPubMedGoogle Scholar
  • 18 Mehta R, Mankekar G, Mayland E, Melder K, Arriaga MA. Endoscopic Inside-Out Mastoidectomy with the Ultrasonic Bone Aspirator. OTO Open 2019; 3 (01) X18821923
    CrossrefPubMedGoogle Scholar
  • 19 Sajjadi H. Endoscopic transcanal modified canal-wall-down mastoidectomy for cholesteatoma. World J Otorhinolaryngol Head Neck Surg 2017; 3 (03) 153-159 DOI: 10.1016/j.wjorl.2017.08.003.
    CrossrefPubMedGoogle Scholar
  • 20 Trahan JR, Mehta R. Transcanal Endoscopic Inside-out Mastoidectomy: Our experience. Otolaryngol Head Neck Surg 2018; 159 (1, suppl) 258-286
    PubMedGoogle Scholar
  • 21 Kapadiya M, Tarabichi M. An overview of endoscopic ear surgery in 2018. Laryngoscope Investig Otolaryngol 2019; 4 (03) 365-373
    CrossrefPubMedGoogle Scholar
  • 22 Tarabichi M. Endoscopic management of limited attic cholesteatoma. Laryngoscope 2004; 114 (07) 1157-1162
    CrossrefPubMedGoogle Scholar