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Transcanal endoscopic surgery offers advantages for congenital cholesteatoma (CC) which is expanding cystic mass located on an intact tympanic membrane. To determine the efficacy of transcanal endoscopic ear surgery for the treatment of CC. Eleven patients with CC confined to the middle ear underwent transcanal endoscopic ear surgery by surgeons who were skilled in otoscopic surgery. According to the Potsic classification, four, three, and four patients had lesions in stages 1, 2, and 3, respectively. The mean follow-up duration was 24.5 months. We retrospectively analyzed the recurrence rate, complications, and average hearing thresholds of the patients with CC. All CCs were successfully resected  via  the transcanal endoscopic approach, without any immediate or serious complications. The only complication was external auditory canal stenosis due to postoperative scarring, which occurred in a patient with a stage-3 cholesteatoma that recurred and required reoperation and second-stage ossicular chain reconstruction. Two more patients underwent one-stage ossicular chain reconstruction. All three patients received a total artificial ossicular replacement prosthesis, and two of them also received cartilage grafts. Transcanal endoscopic ear surgery is an effective method to treat CC belonging to Potsic stages 3 or below.

Outcomes of transcanal endoscopic middle ear surgery for congenital cholesteatoma