title: Is endoscopic ear surgery an alternative to the modified Bondy technique for limited epitympanic cholesteatoma?
abstract: The objective of this study is to evaluate the outcomes of the modified Bondy's technique performed at our center and for limited epitympanic cholesteatomas and to debate the purported benefits of endoscopic surgery for the same indication. This is a retrospective study. 269 ears of 258 patients with a minimum of 5-year follow-up that were operated for limited epitympanic cholesteatoma using the modified Bondy's technique were included in the study. All patients had primary acquired cholesteatoma with good preoperative hearing in the affected ear and an intact ossicular chain. The outcomes of were analyzed and the results were compared with a literature review of outcomes of endoscopic ear surgery for the same indication. The mean follow-up was 81.63 months. The mean preoperative air-bone gap was 13.6 ± 7 dB. Intraoperatively, the ossicular chain was preserved in all patients. Postoperatively, there was no significant change from preoperative levels in mean air conduction, mean bone conduction and the air-bone gap. There were no recurrent cholesteatomas in our series. A residual pearl-like cholesteatoma was found lateral to the tympanic membrane in 8.1 % of ears, which was removed in the outpatient clinic. Three patients (1.2 %) developed stenosis of the meatoplasty. Eight (3.1 %) ears exhibited retraction pockets involving the attic. Postoperative ear discharge was observed in 1.5 % cases. The modified Bondy technique, which provides excellent postoperative outcomes, is the surgery of choice for limited epitympanic cholesteatomas. The endoscope, despite its better visualization of hidden areas does not provide a distinct overall technical advantage or better results over the microscope.
authors.affiliation: Department of Otology and Skull Base Surgery, Gruppo Otologico, C/o Casa di Cura Piacenza Privata spa, Via Emmanueli, 42, Piacenza, Rome, 29121, Italy. sampathcp@yahoo.co.in.|Department of Otolaryngology-Head and Neck Surgery, Military Hospital, Hisar, India. sampathcp@yahoo.co.in.
authors.forename: Sampath Chandra
authors.identifier: http://orcid.org/0000-0002-7989-4304
authors.initials: SC
authors.lastname: Prasad
authors.affiliation: Department of Otology and Skull Base Surgery, Gruppo Otologico, C/o Casa di Cura Piacenza Privata spa, Via Emmanueli, 42, Piacenza, Rome, 29121, Italy.|Department of Otolaryngology-Head and Neck Surgery, Military Hospital, Hisar, India.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Giannuzzi
authors.affiliation: Department of Otology and Skull Base Surgery, Gruppo Otologico, C/o Casa di Cura Piacenza Privata spa, Via Emmanueli, 42, Piacenza, Rome, 29121, Italy.|Department of Otolaryngology-Head and Neck Surgery, Military Hospital, Hisar, India.|Department of Otolaryngology-Head and Neck Surgery, Jordanian Royal Medical Services, Amman, Jordan.
authors.forename: Eyad Abu
authors.initials: EA
authors.lastname: Nahleh
authors.affiliation: Department of Otology and Skull Base Surgery, Gruppo Otologico, C/o Casa di Cura Piacenza Privata spa, Via Emmanueli, 42, Piacenza, Rome, 29121, Italy.|Department of Otolaryngology-Head and Neck Surgery, Military Hospital, Hisar, India.
authors.forename: Giuseppe De
authors.initials: GD
authors.lastname: Donato
authors.affiliation: Department of Otology and Skull Base Surgery, Gruppo Otologico, C/o Casa di Cura Piacenza Privata spa, Via Emmanueli, 42, Piacenza, Rome, 29121, Italy.|Department of Otolaryngology-Head and Neck Surgery, Military Hospital, Hisar, India.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Russo
authors.affiliation: Department of Otology and Skull Base Surgery, Gruppo Otologico, C/o Casa di Cura Piacenza Privata spa, Via Emmanueli, 42, Piacenza, Rome, 29121, Italy.|Department of Otolaryngology-Head and Neck Surgery, Military Hospital, Hisar, India.
authors.forename: Mario
authors.initials: M
authors.lastname: Sanna
mesh_terms: D000328:Adult; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis / Q000601:surgery; D057186:Comparative Effectiveness Research; D004429:Ear Ossicles / Q000503:physiopathology; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006320:Hearing Tests / Q000379:methods; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D059351:Organ Sparing Treatments / Q000379:methods; D013506:Otologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D014432:Tympanic Membrane / Q000473:pathology / Q000503:physiopathology
keywords: Endoscopic ear surgery; Limited epitympanic cholesteatoma; Modified Bondy technique; Outcomes