显微镜联合耳内镜手术治疗中耳胆脂瘤的临床效果

Objective To evaluate the clinical outcomes of combined microscopic and endoscopic ear surgery in the treatment of middle ear cholesteatoma. Methods A total of 108 patients who underwent middle ear cholesteatoma surgery in the First People's Hospital of Hechi from January 2021 to June 2025 were retrospectively enrolled. All patients underwent high-resolution middle ear mastoid CT before operation to evaluate the involvement of tympanic cavity, tympanic sinus and mastoid. According to the operation method, they were divided into microscopic group(n=36), endoscopic group(n=36) and endoscopic combined group(n=36). Surgical indicators, efficacy indicators and safety indicators were compared among the three groups. Results After treatment, the surgical indicators of the double-scope combined group were better than those of the microscopic group and the endoscopic group(P<0.05). The dry ear rate and hearing ability in the combined group were higher than those in the microscopic group and the endoscopic group at 3 months after operation, and the recurrence rate of the surgical hand in the combined group was lower than that in the microscopic group and the endoscopic group at 12 months after operation(P<0.05). There was no significant difference in the incidence of complications among the three groups(P>0.05). Conclusion The combined use of microscopy and endoscopy via posterior or modified transcanal incisions enables accurate assessment of cholesteatoma extent, provides reliable guidance for selecting surgical approaches and exposure strategies, improves dry ear rates, and reduces recurrence. Clinicians may choose the most appropriate surgical method according to individual patient conditions.