New technique for ear surgery leads to better outcomes

A cholesteatoma is an abnormal, cyst-like growth of skin behind the eardrum. The growths most commonly affect children and young adults who have had chronic otitis media (glue ear) or chronic ear disease, and they may also occur congenitally. While cholesteatomas are not malignant they can, if left untreated, cause serious damage to the middle and inner ear, affecting hearing and balance.

The most common treatment is surgical removal of the growth, however this is not without risk as the procedure involves cutting through the delicate tissue of the middle ear.

Deafness Research UK recently gave a grant to David Pothier, a Specialist Registrar in Otorhinolaryngology at the Royal United Hospital in Bath, to enable him to go overseas to learn about a safer technique for cholesteatoma surgery.

An endoscope is an instrument normally consisting of a tube, a light and a lens, that can be used to look inside the body and to conduct biopsies without the need for making an external incision. Its use in cholesteatoma surgery has been pioneered by Dr Muaaz Tarabichi at the American Hospital in Dubai but is not yet practised in this form in the UK. As the technique is relatively non-invasive, it can reduce hospital stay. “This is of particular importance in children, who constitute a significant proportion of patients undergoing this operation”, says Mr Pothier. The visit to Dubai enabled him to attend surgery and learn the most effective techniques for conducting the procedure.