Effectiveness and Safety of Otoendoscopic Surgery Using Attic Exposition-Antrum Exclusion Versus Microscopic Canal Wall-up Tympanomastoidectomy in Patients With Acquired Cholesteatoma Stages IB and II Affecting the Tympanic Cavity and Attic

The aim of this study is to test the effectiveness and safety of AE-AE surgery combining otoendoscopy and surgical microscopy in the treatment of acquired pars flaccida cholesteatoma in stages Ib and II of the Japan Otological Society classification occupying the tympanic cavity and attic. A historical cohort study on 65 patients. Of the total, 44 patients were treated by AE-AE surgery using an otoendoscope and 21 with canal wall-up tympanomastoidectomy (CWUT). Patients in whom the AE-AE technique was performed had a lower recurrence rate (9%) compared to those treated with CWUT (38%); p=0.013. In addition, the median time to recurrence was lower in the AE-AE group (4 years [P25-75= 1.25-2-75]) than in CWUT group (2 years [P25-75= 3.25-4.75]); p=0.048. Thresholds were higher in the CWUT group compared to the AE-AE group in pre-surgery (53±16 vs 44±15; p=0.039) and post-surgery (52±18 vs 42±16 dB dB; p=0.042), but not in pre-post-surgery comparisons neither in the AE-AE technique (p= 0.89) nor in the CWUT technique (p= 0.96). We concluded that AE with otoendoscopic support is an effective and safe technique for acquired cholesteatomas occupying box and attic in stages IB and II.