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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2023; 27(02): e370-e376
DOI: 10.1055/s-0043-1768202
Systematic Reviews

Inside-Out Transcanal Endoscopic Mastoidectomy: Literature Revision

Renan Gonçalves Bessa 
1   Department of Otorhinolaryngology, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil
,
Robinson Koji Tsuji 
1   Department of Otorhinolaryngology, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil
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Abstract

Introduction Recently, there have been significant advancements in transcanal endoscopic ear surgery (TEES). The combination of rigid and thin otoendoscopes with high-definition cameras enabled a less invasive transcanal access to the middle ear and a clearer view of the surgical field. Several surgeons have recently published studies about cholesteatoma resection via transcanal endoscopic surgery, even in cases where the disease has extended to the mastoid, requiring transcanal endoscopic mastoidectomy.

Objectives To analyze the currently available literature on transcanal endoscopic inside-out mastoidectomy, and to determine its efficacy as a surgical technique by evaluating the disease's relapse/recurrence rate.

Data Synthesis Initially, the titles and abstracts of articles identified were analyzed. At this stage, 117 articles were analyzed, 97 of which were excluded for not meeting the inclusion criteria. The 20 remaining articles were further evaluated. The articles were classified on the basis of five levels of scientific evidence.

Final Comments The analysis of the studies showed that the transcanal endoscopic approach is effective in providing access to the attic or antrum, especially in cases of sclerotic mastoids. There was only one study with grade A recommendation, which showed the efficacy of endoscopic ear surgery in the treatment of cholesteatoma. Furthermore, there were three studies with grade B recommendation, showing less relapse/recurrence after TEES. More studies with grade A and B recommendations are needed to better evaluate the effectiveness of TEES, especially compared with that of traditional microscopic surgery.

Keywords

grade - endoscopic - recommendation - cholesteatoma - otology - neurotology


Publikationsverlauf

Eingereicht: 01. September 2021

Angenommen: 27. Oktober 2021

Artikel online veröffentlicht:
28. April 2023

© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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