The using of endoscopic technology in children with petrous bone cholesteatoma
Kh. M. Diab,
N. A. Daikhes,
O. A. Paschinina,
T. I. Garashchenko,
O. S. Panina,
S. V. Kokhanyuk,
P. A. Safarova https://doi.org/10.21518/ms2024-258
Abstract
Introduction. Endoscopic ear surgery is a promising treatment for petrous bone cholesteatoma in children. Endoscopic assistance provides better visualization and the ability to manipulate in hidden areas of the formed cavity and facilitate the removal of cholesteatoma matrix from hard-to-reach areas.
Aim. o systematize the accumulated knowledge about the clinical presentations of cholesteatoma of the temporal bone pyramid in children, review the modern methods of treatment and possible complications, and assess the necessity of applying endoscopic imaging devices to monitor hard-to-reach places in the temporal bone pyramid.
Materials and methods. The results of surgical treatment of petrous bone cholesteatoma (PBC) in the immediate and long-term postoperative periods in children were assessed. The study included 26 children aged 8 to 18 years (average age 13.1), 21 boys and 5 girls. Dynamic follow-up after surgery was at least two years. The function of facial muscles was assessed using the House – Brackmann scale before and after surgery after 6 months, and a pure-tone audiogram was performed before and after surgery after 6 months. The approaches, options for completing the operation, complications, and relapse rates are presented.
The discussion of the results. In the postoperative period, 2 people (7.7%) had normal hearing according to audiometry results, 1 (3.8%) had I degree of hearing loss, 5 (19.2%) had II degree of hearing loss, 6 (23.0%), III degree of hearing loss, in 7 (27.0%) IV degree of hearing loss, in 5 (19.2%) deafness. Function in the postoperative period was normal in 15 (57.0%) and from House – Brackmann grades II to VI in 11 (43.0%). Recurrence of cholesteatoma was detected in eight patients (30.0%) after 1–2 years.
Conclusion. In children, early diagnosis of cholesteatoma of the petrous bone is important to prevent the risk of complications. The use of endoscopic assistance when removing cholesteatoma of the petrous bone provides advantages: the ability to remove the cholesteatoma matrix in hidden areas, provides a larger viewing angle and control of these areas, thereby minimizing the risks of intraoperative complications, allowing for maximum sanitization of the pathological process.
About the Authors
Kh. M. Diab
The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia; Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Khassan M. Diab, Dr. Sci. (Med.), Deputy Director for International Affairs, Сhief of the Scientific Department of Otology and Skull Base pathologies; Professor of the Department of Otorhinolaryngology Postgraduate Education
30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182
1, Ostrovityanov St., Moscow, 117997
N. A. Daikhes
The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia; Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Nikolai A. Daikhes, Corr. Member RAS, Dr. Sci. (Med.), Professor, Director
30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182
1, Ostrovityanov St., Moscow, 117997
O. A. Paschinina
The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia
Russian Federation
Russian Federation
Olga A. Paschinina, Cand. Sci. (Med.), Сhief of the Clinical Department of Otology and Skull Base pathologies
30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182
T. I. Garashchenko
The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia; Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Tatiana I. Garashchenko, Dr. Sci. (Med.), Professor, Scientific Secretary, Federal State Budgetary Institution «Scientific and Clinical Center of Otorhinolaryngology; Professor of the Department of Otorhinolaryngology
30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182
1, Ostrovityanov St., Moscow, 117997
O. S. Panina
The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia
Russian Federation
Russian Federation
Olga S. Panina, Otorhinolaryngologist, Junior Researcher at the Scientific and Clinical Department of “Pathology of the ear and skull base”
30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182
S. V. Kokhanyuk
The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia
Russian Federation
Russian Federation
Svetlana V. Kokhanyuk, Otorhinolaryngologist, Junior Researcher at the Scientific and Clinical Department of “Pathology of the Ear and Skull Base”
30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182
P. A. Safarova
The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia
Russian Federation
Russian Federation
Patima A. Safarova, Otorhinolaryngologist, Pediatric Department of “Pathology of the ear and skull base”
30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182
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For citations:
Diab KM, Daikhes NA, Paschinina OA, Garashchenko TI, Panina OS, Kokhanyuk SV, Safarova PA. The using of endoscopic technology in children with petrous bone cholesteatoma. Meditsinskiy sovet = Medical Council. 2024;(11):240–248. (In Russ.) https://doi.org/10.21518/ms2024-258
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