title: Pediatric Endoscopic Cholesteatoma Surgery.
abstract: (1) To describe and review a single center's pediatric endoscopic cholesteatoma experience, including surgical and audiologic outcomes. (2) To assess the most common locations of residual cholesteatoma following endoscopic removal.
  
  
  
  Case series with chart review.
  
  
  
  Tertiary otologic referral center.
  
  
  
  Patients <19 years of age who underwent cholesteatoma removal with either endoscopic or microscopic visualization.
  
  
  
  In a comparison of patients who underwent total endoscopic ear surgery (TEES), combined endoscopic-microscopic surgery, or microscopic surgery, analyzed outcomes included locations and incidence of recurrent and residual cholesteatoma, complications, and audiometric testing.
  
  
  
  Sixty-six patients (mean age, 10.9 years; range, 4-18 years; 43.4% female) with 76 ears met inclusion criteria. The average overall follow-up was 18.8 months (range, 6.7-48.3). Forty-seven (61.8%) ears underwent microscopic removal of cholesteatoma; 29 (38.1%) ears underwent combined endoscopic-microscopic removal; and 8 (10.5%) ears underwent TEES removal. Significantly more mastoidectomies were completed in microscopic cases as compared with endoscopic cases (P = .049). Though second-look procedures occurred in 15 (51.7%) endoscopic cases and 10 (21.3%) microscopic cases (P = .006), the rate of residual disease was 20.0% and 40.0% in endoscopic and microscopic cases, respectively (P = .38). When controlling for preoperative hearing, only the air-bone gap for TEES demonstrated significant improvement (P = .009). No complications were noted.
  
  
  
  The present report describes our experience with pediatric endoscopic cholesteatoma surgery, demonstrating similar hearing outcomes, rates of recurrence and residual disease, and complication rates as compared with traditional microscopic techniques.
authors.affiliation: The Otology Group, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Hunter
authors.affiliation: The Otology Group, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: M Geraldine
authors.initials: MG
authors.lastname: Zuniga
authors.affiliation: The Otology Group, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Alex D
authors.initials: AD
authors.lastname: Sweeney
authors.affiliation: The Otology Group, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Natalie M
authors.initials: NM
authors.lastname: Bertrand
authors.affiliation: The Otology Group, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: George B
authors.initials: GB
authors.lastname: Wanna
authors.affiliation: The Otology Group, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Haynes
authors.affiliation: The Otology Group, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Wootten
authors.affiliation: The Otology Group, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA alejandro.rivas@vanderbilt.edu.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rivas
mesh_terms: D000293:Adolescent; D001299:Audiometry; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D013506:Otologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D016896:Treatment Outcome
keywords: cholesteatoma; endoscopic ear surgery; ossiculoplasty; pediatric; tensor fold