Outcomes from cholesteatoma surgery are improved by using endoscopes to guide dissection as the wide-angled view facilitates more complete removal of cholesteatoma matrix, reducing the risk of residual disease. Furthermore, surgery can often be completed transcanal, reducing postoperative morbidity. The decision to complete cholesteatoma removal endoscopically transcanal is made from a combination of preoperative imaging and intraoperative findings. A one-handed approach to operating is required as the other hand is used to optimize endoscope positioning. Aspects of technique and instrumentation particular to endoscopic cholesteatoma surgery are presented.
