소아 선천성 진주종 제거 시 내시경을 이용한 수술의 유용성
Usefulness of Endoscopic Removal of Congenital Cholesteatoma in Children
2
조회
0
다운로드
4
인용
0
참고문헌
초록
Background and Objectives The use of endoscope has led to new treatment options for middle ear pathologies. The aim of this study is to report on endoscopic ear surgeries for the removal of middle ear cholesteatoma and discuss about the usefulness of endoscopic approach to congenital cholesteatoma in children. Subjects and Method Five pediatric patients with congenital cholesteatoma were enrolled in this study. Cholesteatoma was removed via transcanal endoscopic approach in all patients. Medical records were reviewed retrospectively. We analyzed the clinical characteristics, surgical management and treatment outcomes. Results The average age of patients was 3.7 years. Cholesteatoma was observed in the anterior portion of tympanic membrane in four patients, and in the posterior portion in one patient. Endoscopic techniques were used exclusively in four patients, but one patient was treated by microscopic approach using a combined technique. Cholesteatoma was fully removed and we confirmed by endoscopic examination that no remnant lesions remained. Surgical complications such as vertigo, sensorineural hearing loss, infection, or bleeding were not seen postoperatively. Average hospital stay was 1.2 days. Conclusion Results showed that this technique was beneficial for treating cholesteatoma in limited cases. Endoscopic surgical techniques produced good intraoperative and postoperative results in removing pediatric congenital cholesteatoma and will gain importance in the otological surgery in the future. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(3):194-201
Abstract
Background and Objectives The use of endoscope has led to new treatment options for middle ear pathologies. The aim of this study is to report on endoscopic ear surgeries for the removal of middle ear cholesteatoma and discuss about the usefulness of endoscopic approach to congenital cholesteatoma in children. Subjects and Method Five pediatric patients with congenital cholesteatoma were enrolled in this study. Cholesteatoma was removed via transcanal endoscopic approach in all patients. Medical records were reviewed retrospectively. We analyzed the clinical characteristics, surgical management and treatment outcomes. Results The average age of patients was 3.7 years. Cholesteatoma was observed in the anterior portion of tympanic membrane in four patients, and in the posterior portion in one patient. Endoscopic techniques were used exclusively in four patients, but one patient was treated by microscopic approach using a combined technique. Cholesteatoma was fully removed and we confirmed by endoscopic examination that no remnant lesions remained. Surgical complications such as vertigo, sensorineural hearing loss, infection, or bleeding were not seen postoperatively. Average hospital stay was 1.2 days. Conclusion Results showed that this technique was beneficial for treating cholesteatoma in limited cases. Endoscopic surgical techniques produced good intraoperative and postoperative results in removing pediatric congenital cholesteatoma and will gain importance in the otological surgery in the future. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(3):194-201
참고문헌 (25)
- Kuo CL, "A review of current progress in acquired cholesteatoma management", Eur Arch Otorhinolaryngol, 272(12), pp.3601~3609 (2015)
- Bottrill ID, "Endoscope-assisted ear surgery", Am J Otol, 16(2), pp.158~163 (1995)
- Rosenberg SI, "Use of endoscopes for chronic ear surgery in children", Arch Otolaryngol Head Neck Surg, 121(8), pp.870~872 (1995)
- Sohn SJ, "Endoscopic tympanoplasty", Korean J Otolaryngol-Head Neck Surg, 43(6), pp.598~603 (2000)
- Jang CH, "Endoscopic approach to tympanic sinus during tympanomastoidectomy for cholesteatoma", Korean J Otolaryngol-Head Neck Surg, 44(1), pp.32~36 (2001)
- Sohn SJ, "Endoscopic revision surgery of middle ear", Korean J Otolaryngol-Head Neck Surg, 44(6), pp.595~599 (2001)
- Levenson MJ, "Congenital cholesteatomas of the middle ear in children: origin and management", Otolaryngol Clin North Am, 22(5), pp.941~954 (1989)
- Potsic WP, "A staging system for congenital cholesteatoma", Arch Otolaryngol Head Neck Surg, 128(9), pp.1009~1012 (2002)
- Potsic WP, "Congenital cholesteatoma: 20 years’ experience at The Children’s Hospital of Philadelphia", Otolaryngol Head Neck Surg, 126(4), pp.409~414 (2002)
- 김형종, "선천성 진주종의 진단 및 치료", 대한이비인후과학회지 두경부외과학, 56(8), pp.482~489 (2013), 대한이비인후과학회[DOI]
- Levi J, "Pie-slice tympanoplasty for transcanal removal of small congenital cholesteatoma", Int J Pediatr Otorhinolaryngol, 76(11), pp.1583~1587 (2012)
- Richter GT, "Contemporary assessment and management of congenital cholesteatoma", Curr Opin Otolaryngol Head Neck Surg, 17(5), pp.339~345 (2009)
- Ko KR, "Mastoidoscopy for second look operation in residual cholesteatoma", Korean J Otolaryngol, 37(5), pp.932~935 (1994)
- McKennan KX, "Endoscopic ‘second look’ mastoidoscopy to rule out residual epitympanic", mastoid cholesteatoma, 1993, pp.103(7), 810~814
- Ayache S, "Otoendoscopy in cholesteatoma surgery of the middle ear: what benefits can be expected?", Otol Neurotol, 29(8), pp.1085~1090 (2008)
- Presutti L, "Results of endoscopic middle ear surgery for cholesteatoma treatment: a systematic review", Acta Otorhinolaryngol Ital, 34(3), pp.153~157 (2014)
- Marchioni D, "Transcanal endoscopic approach to the sinus tympani: a clinical report", Otol Neurotol, 30(6), pp.758~765 (2009)
- Presutti L, "Endoscopic management of acquired cholesteatoma: our experience", J Otolaryngol Head Neck Surg, 37(4), pp.481~487 (2008)
- Marchioni D, "Endoscopic approach to tensor fold in patients with attic cholesteatoma", Acta Otolaryngol, 129(9), pp.946~954 (2009)
- Marchioni D, "Endoscopic exclusive transcanal approach to the tympanic cavity cholesteatoma in pediatric patients: our experience", Int J Pediatr Otorhinolaryngol, 79(3), pp.316~322 (2015)
- Marchioni D, "Ossicular chain preservation after exclusive endoscopic transcanal tympanoplasty: preliminary experience", Otol Neurotol, 32(4), pp.626~631 (2011)
- Csakanyi Z, "Middle ear gas pressure regulation: the relevance of mastoid obliteration", Otol Neurotol, 35(6), pp.944~953 (2014)
- Cinamon U, "Mastoid and tympanic membrane as pressure buffers: a quantitative study in a middle ear cleft model", Otol Neurotol, 24(6), pp.839~842 (2003)
- Borgstein J, "Erosion of the incus in pediatric posterior tympanic membrane retraction pockets without cholesteatoma", Int J Pediatr Otorhinolaryngol, 72(9), pp.1419~1423 (2008)
- Dornhoffer JL, "Retrograde mastoidectomy with canal wall reconstruction: a single-stage technique for cholesteatoma removal", Ann Otol Rhinol Laryngol, 109(11), pp.1033~1039 (2000)