Intraoperative endoscopy of the anterior epitympanum recess through the posterior tympanotomy

Abstract

Introduction: The anterior epitympanum recess (AER) is a common place of the development of the cholesteatoma, which is why removal of the matrix from this area plays a key role in the surgical treatment of chronic otitis media.

Aim: To evaluate the intraoperative visibility of AER in endoscopic optics in comparison to microscopic optics and to determine the prevalence of cholesteatoma in various types of construction of the AER. Study design: Retrospective analysis of intraoperative search.

Material and methods: The study included 55 patients treated in the Department of Otolaryngology, Medical University of Warsaw within the years 2009-2011, who underwent endoscopy-assisted canal wall up tympanoplasty with posterior tympanotomy. The type of construction of the AER - cellular or dome-shaped - was determined.

Results: Cellular type of recess was found intraoperatively in 32% of ears and dome-shaped in 68% of the study group. The population with chronic otitis media does not differ significantly compared to the general population in terms of the construction of the anterior epitympanum recess (p = 0.668108; χ ² = 0.1838235, df = 1). Among the ears with cholesteatoma a cellular AER was found in 48.3% of cases and a dome-shaped AER was found in 51.7%.

Conclusions: The cellular type of AER was significantly more frequent in ears with cholesteatoma (p < 0.01, χ² = 29.86492, df = 1). Level of evidence: 1b.