Objective:This study aims to investigate the therapeutic efficacy of staged endoscopic surgery for Shin-Ⅲ stage external auditory canal cholesteatoma. Methods:A retrospective analysis was conducted on the clinical data of 25 patients diagnosed with Shin-Ⅲ cholesteatoma of the external auditory canal, who were admitted to the Otology Center of the First People's Hospital of Foshan City from May 2020 to October 2024. All patients initially underwent endoscopic cholesteatoma removal. Based on the outcomes of the first-stage postoperative follow-up, patients were categorized into two groups: the repair type and the non-repair type. The non-repair type was further subdivided into simple and complex types. Of the total cases, 10 patients were of the repair type, with 9 requiring no further surgical intervention. The non-repair type comprised 15 patients, of which 8 were classified as simple type and underwent either tympanoplasty type Ⅰ or external auditory canal wall reconstruction during the second stage. The remaining 7 patients, identified as complex type, received open mastoidectomy or tympanotomy in the second stage, with or without ossicular chain reconstruction. Results:All patients were monitored for a minimum of six months postoperatively. The incidence of dry ear was observed in 22 patients, corresponding to a dry ear rate of 88.0%. Four cases experienced primary complications. Conclusion:Endoscopic phased operation for managing Shin-Ⅲ stage cholesteatoma of the external auditory canal can ensure that the surgical options match the severity of the lesions, reducing unnecessary surgical trauma and achieving good efficacy.
Humans ; Retrospective Studies ; Ear Canal/surgery* ; Endoscopy/methods* ; Cholesteatoma/surgery* ; Male ; Tympanoplasty ; Female ; Treatment Outcome ; Adult ; Middle Aged ; Cholesteatoma, Middle Ear/surgery* ; Mastoidectomy

Objective To understand the characteristics of the hearing loss in patients with small acoustic neuroma .Methods A retrospective analysis was used to analyze the results of pure tone audiometry (PTA) and au-ditory brainstem response (ABR) in 35 patients (35 ears) diagnosed with small acoustic neuroma .The types of au-diometric curves ,degrees and frequencies of hearing loss and latent periods of ABR were analyzed .Results Moder-ate deafness was the most common type in this study ,with a total of 13 ears (37 .14％ ,13/35) .In addition ,8 ears were profound deafness (22 .86％ ,8/35) ,7 ears of binaural severe deafness (20 .00％ ,7/35) ,6 ears of mild deafness (17 .14％ ,6/35) ,and 1 normal ear (2 .86％ .1/35) ,respectively .The types of audiometric curves were mainly U -shaped and sloping .15 audiometric curves were U -shaped (42 .86％ ,15/35) ,15 sloping (42 .86％ ,15/35) ,3 flat (8 .57％ ,3/35) ,and 1 tent-shaped (2 .86％ .1/35％ ) .The main frequencies of hearing loss were 1 kHz ,2 kHz ,4 kHz ,and 8 kHz .The mean thresholds had statistically significant differences (P<0 .05) compared with the other frequencies by S -N -K test .ABR was abnormal in 32 ears(91 .43％ ,32/35) .20 of the ears'I - V waves were prolonged or the inter-aural latency difference of V wave was>0 .4 ms .Five ears failed to show any ABR wave , but their 4 kHz pure tone threshold was < 80 dB HL .25 (71 .43％ ,25/35)ears'ABR results indicated a retroco-chlear nature of ear disease .Conclusion Moderate deafness is the most common type of hearing loss in small acous-tic neuroma patients ,but only 71 .43％ of the patients'ABR indicate a retrocochlear disease ,so an analysis of PTA together with ABR will help to diagnose .