title: Endoscopic management of acquired cholesteatoma: our experience.
abstract: OBJECTIVE
  The purpose of this study was to examine the utility of using an endoscope in cholesteatoma surgery and to demonstrate how it allows a reduction in the incidence of residual disease.
  
  
  METHODS
  Thirty-two ears with acquired cholesteatoma (primary) were resected. Twenty cases were resected using a canal wall up (CWU) technique and six cases using a canal wall down (CWD) technique, and in six cases, a transcanal tympanotomy-atticotomy was performed. All of the patients in our study group underwent explorative and operative endoscopic ear surgery complementary to use of the operating microscope to uncover and remove residual cholesteatoma.
  
  
  RESULTS
  In the primary surgery after completion of microscopic cleaning, the overall incidence of intraoperative residual disease detected with the endoscope was 37.5%. The sinus tympani was the most common site of intraoperative residual disease, followed by the anterior epitympanic recess and protympanum. Of the 20 CWU cases, 12 second-look endoscopies were performed. Two residuals were identified, both in the sinus tympani. No significant complications were associated with the 32 endoscopic procedures.
  
  
  CONCLUSIONS
  The endoscope allowed a better understanding of cholesteatoma and improved eradication of residual disease from hidden areas such as the anterior epitympanic recess, retrotympanum, and hypotympanum not yet controllable by the operating microscope.
authors.affiliation: Department of Otolaryngology, Policlinico di Modena, Modena, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Presutti
authors.forename: Daniele
authors.initials: D
authors.lastname: Marchioni
authors.forename: Francesco
authors.initials: F
authors.lastname: Mattioli
authors.forename: Domenico
authors.initials: D
authors.lastname: Villari
authors.forename: Matteo
authors.initials: M
authors.lastname: Alicandri-Ciufelli
mesh_terms: D000328:Adult; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome