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This study was conducted to review the value of endoscopic ear surgery as adjunct to microscopic surgery in management of cholesteatoma. It aimed to determine the accessibility of hidden sites and to assess surgical outcomes in cholesteatoma surgery with the adjunct use of an endoscope. An extensive review of literature on PubMed was performed to select studies about the use of an endoscope either as an adjunct to or as a replacement for a microscope in cholesteatoma surgery and studies with comparative surgical outcomes of endoscopic ear surgery and microscopic ear surgery in cholesteatoma surgery. The majority of the studies use endoscopic ear surgery as an adjunct or combined with traditional microscopic ear surgery (observational or operative) while a minority use exclusive transcanal endoscopic cholesteatoma surgery. Endoscopic ear surgery in cholesteatoma provides superior visualization of hidden areas with highest risk for residual cholesteatoma, like the sinus tympani. The use of an endoscope showed reducing residual and recurrence cholesteatoma, especially in canal wall up procedure. Transcanal endoscopic cholesteatoma surgery is minimally invasive and uses a natural access and a step-by-step pursuit of cholesteatoma through the middle ear. This review acknowledges the value of microscopic ear surgery but highlights the benefit of endoscopic ear surgery in cholesteatoma surgery, whether used combined or exclusively, by enhanced visualization and ability to visualize hidden areas for identification and removal of cholesteatoma residues and by so reducing recurrence. Endoscopic ear surgery helps in decision making intraoperatively and in preventing unnecessary tissue removal. However, the microscope affords greater comfort in mastoid drilling and cannot be replaced by the endoscope in all cases.
Cite this article as: Levie C, Levie P. Use of endoscopic ear surgery as adjunct to microscopic surgery in cholesteatoma surgery. B-ENT 2023. [epub ahead of print]