[Efficacy of inverted door flap combined with transcanal approach to the tympanic antrum technique for the treatment of middle ear cholesteatoma under endoscope]

Abstract

This study aimed to investigate the efficacy of inverted door flap (IDF) combined with transcanal approach to the tympanic antrum (TCAA) technique under the endoscope for treatment of middle ear cholesteatoma. Outcomes of patients treated with combined techniques at the First People's Hospital of Foshan City between March 2021 and March 2023 were evaluated. A total of 31 patients (33 ears, 16 males and 15 females) aged (42.9±15.9) years were included. The patients were divided into three groups based on the extent of cholesteatoma involvement: the lateral ossicular chain (LOC) group (8 ears), the internal ossicular chain (IOC) group (11 ears), and the mastoid antrum and mastoid process (MA/MP) group (14 ears). No complications occurred postoperatively, such as cholesteatoma recurrence, facial paralysis and infection. The median (Q₁, Q₃) follow-up duration was 12 (7, 18) months. The results showed a median (Q₁, Q₃) dry ear duration of 1.5 (1.5, 2.0) months, and a dry ear rate of 97.0% (32/33) at six months postoperatively. Specifically, 7 out of 8 patients in the LOC group had dry ears, while all patients in the IOC group and the MA/MP group had dry ears 6 months after surgery. The current study demonstrates that IDF combined with TCAA techniques are safe and effective in the treatment of middle ear cholesteatoma, with rapid achievement of dry ear.