TEES for Cholesteatoma
For this condition, the graft tissue, including the perichondrium and
cartilage, was also harvested from the meatal surface of the tragus.
Then, an elongated transmeatal incision was made to elevate the
tympanomeatal flap. Next, the scutum was drilled to expose the attic
area. The dissection was extended along the cholesteatoma to the bottom
of the matrix until the cholesteatoma could be completely removed. If
the ossicular chain was involved and destroyed by the cholesteatoma,
ossiculoplasty was performed simultaneously as necessary. The
reconstruction procedure was slightly modified according to the extent
of the dissection in each case. In patients who had limited
cholesteatomas confined within the attic, the tympanic cavity and scutum
were reconstructed using the composite cartilage and perichondrium
(close cavity procedure) (Figure 1) [20]. In patients who had
advanced disease involving the mastoid cavity proper, we reconstructed
only the tympanic cavity and left the mastoid antrum as an open cavity
in the ear canal (open cavity procedure).
The performance of all of the above TEES procedures left no surgical
wound outside the ear canal. After the operations, patients were
regularly followed up in the outpatient clinic for 18 to 48 months. For
patients who underwent tympanoplasty, successful surgery was defined as
complete healing of the tympanic membrane; for those with
cholesteatomas, it was defined as complete removal of the cholesteatoma
without any residual or recurrent disease during the postoperative
follow-up.