{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T16:14:07Z","timestamp":1771258447024,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,12,31]],"date-time":"2015-12-31T00:00:00Z","timestamp":1451520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Routine endoscopic examination during primary surgery decreased the rate of residual cholesteatoma to 18% in our early experience. Based on this, we stopped performing routine second\u2010look surgery in children who were endoscopically free of cholesteatoma at the end of primary surgery. We sought to investigate if second\u2010look procedures after endoscopic\u2010assisted surgery could safely be performed only in children at a high risk of residual disease (extensive inflammation, spontaneously ruptured or fragmented cholesteatoma, residual disease intentionally left).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary pediatric otolaryngology practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Children aged 1 to 16 years who were treated for cholesteatoma over 15\u2010year period by a single surgeon. Extent of disease and endoscopic findings were compared with rates of residual disease. Time to diagnosis of residual disease and prognostic factors were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two children underwent endoscopically assisted middle ear surgery for cholesteatoma. Of 42 children, 7 (17%) had additional disease found by endoscopy that was missed by microscopy alone. Twelve children at high risk had second looks; 5 (42%) had residual disease. Of 30 children, 2 (7%) presented with macroscopically evident residual cholesteatoma after no planned second look on office follow\u2010up and subsequently underwent reoperation and were cured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Selective second\u2010look surgery in high\u2010risk children did not adversely affect outcome as compared with the low\u2010risk group. Cholesteatoma was identified endoscopically in 7 of 42 (17%) children thought to be microscopically free of disease at initial surgery. The endoscope may aid in visualization of difficult middle ear recesses when used to complement microscopy. Further investigation with multicenter data is needed.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599815622441","type":"journal-article","created":{"date-parts":[[2015,12,31]],"date-time":"2015-12-31T23:03:02Z","timestamp":1451602982000},"page":"535-539","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Long\u2010term Results of Endoscopically Assisted Pediatric Cholesteatoma Surgery"],"prefix":"10.1002","volume":"154","author":[{"given":"David","family":"Sarcu","sequence":"first","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery Temple University School of Medicine Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Isaacson","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery Temple University School of Medicine Philadelphia Pennsylvania USA"},{"name":"Department of 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