title: Curved adjustable fiberoptic laser for endoscopic cholesteatoma surgery.
abstract: OBJECTIVE
  To determine whether endoscopic cholesteatoma removal can be performed efficiently and safely using a curved fiberoptic-based laser.
  
  
  BACKGROUND
  Angled instruments are required in endoscopic ear surgery to access recesses of the middle ear without extra drilling. Lasers are effective at ablating visible and microscopic cholesteatoma matrix and removing granulation tissue.
  
  
  METHODS
  Retrospective case review from 2006 to 2013.
  
  
  METHODS
  Single tertiary care center.
  
  
  METHODS
  Patients who underwent cholesteatoma surgery with otoendoscopy.
  
  
  METHODS
  Residual cholesteatoma that could not be reached by conventional microinstruments was identified using an endoscope. This residual cholesteatoma was ablated in a contactless manner using a fiberoptic-based curved laser carrier with an argon laser. The laser tip through the carrier probe has a 45-degree curve, and the length of the tip is adjustable, allowing it to be used in recesses or around corners, such as in the sinus tympani, around the stapes suprastructure, in the oval window, or in the Eustachian tube orifice.
  
  
  METHODS
  Presence or absence of residual cholesteatoma after laser ablation and complications.
  
  
  RESULTS
  In 7 cases, the fiberoptic curved laser was used to ablate cholesteatoma completely with no injury to surrounding structures and with no evidence of recidivism with a mean follow-up period of 19 months. There were no cases of sensorineural hearing loss or perilymphatic fistula.
  
  
  CONCLUSIONS
  The curved laser probe allows for precise removal of cholesteatoma endoscopically.
authors.affiliation: *Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, and †Department of Biomedical Engineering, University of California, Irvine, California, U.S.A.
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Yau
authors.forename: Hossein
authors.initials: H
authors.lastname: Mahboubi
authors.forename: Marlon
authors.initials: M
authors.lastname: Maducdoc
authors.forename: Yaser
authors.initials: Y
authors.lastname: Ghavami
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Djalilian
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D004432:Ear, Middle / Q000601:surgery; D004724:Endoscopy / Q000295:instrumentation; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult