Transcanal Endoscopic Atticotomy for Squamous Type of Chronic Otitis Media – Our Experience

Document Type : Original Article

Authors

1 Assistant Professor, Department of ENT, Sree Balaji Medical College and Hospital, Chromepet, Chennai Bharath Institute of Higher Education and Research

2 Professor, Department of ENT, Sree Balaji Medical College Bharath Institute of Higher Education and Ressearch

Abstract

Introduction: Endoscopic ear surgery has changed the way otologists approach cholesteatoma and canal wall down surgery. This study aims to evaluate the outcomes of an endoscopic approach to patients with cholesteatoma limited to the attic and antrum.
Objectives: To study the outcomes in patients undergoing endoscopic atticotomy in terms of postop pain, hearing improvements, graft uptake and complications.
Materials and Methods: A prospective study was conducted in a tertiary care private referral hospital between December 2019 and January 2022 and included 40 consecutive patients with chronic otitis media of squamosal type – with disease limited to attic & antrum. All patients underwent endoscopic atticotomy or attico-antrosotomy with/ without cartilage tympanoplasty. All were evaluated at 3 months, 6 months and 12 months after surgery. The parameters evaluated were in terms of postoperative pain, hearing improvement, graft uptake, and postop complications.
Results: Of the 40 patients, 14 (35%) patients had cholesteatoma restricted to attic and antrum, 18 (45%) patients had posterosuperior retraction pocket and 8 (20%) patients had aural polyp on presentation. Type 3 tympanoplasty was the most common type of surgery performed. There was a significant decrease in the air bone (AB) conduction gap after tympanoplasty (43.98 vs 26.58) indicating improvement in the hearing [t-value [95% CI] >16.68 [15.29 to 19.51] (P<0.05).
Conclusions: The study showed that this approach is a very rewarding procedure to the patient, in terms of reduced hospital stay, post op complications, pain, scarring, and cavity problems but with similar hearing levels when compared to the traditional mastoidectomy.

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