{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:35:22Z","timestamp":1771234522838,"version":"3.50.1"},"reference-count":63,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cPublish not Perish 2025\u201d program of Carol Davila University of Medicine and Pharmacy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cholesteatoma is a destructive middle ear lesion that compromises hearing and quality of life, for which endoscopic ear surgery (EES) has emerged as a minimally invasive alternative to microscopic approaches. While recurrence and audiological outcomes are frequently reported, patient-centered evaluations using validated patient-reported outcome measures (PROMs) remain limited. Objective: This study aimed to assess postoperative quality of life in patients undergoing exclusive endoscopic cholesteatoma surgery, using validated patient-reported outcome measures. Methods: We conducted a prospective observational cohort study in a tertiary referral center, enrolling 41 patients who underwent exclusive endoscopic cholesteatoma surgery over 20 months. Pre- and postoperative QoL was assessed using the Chronic Otitis Media Questionnaire-12 (COMQ-12) and the Glasgow Benefit Inventory (GBI). Results: COMQ-12 scores improved significantly from baseline (54.0 \u00b1 4.2) to 12 months (10.2 \u00b1 3.3; mean difference \u221243.8, 95% CI: \u221246.1 to \u221241.5; p &lt; 0.001). GBI scores were consistently high, increasing from 82.6 \u00b1 4.8 at 6 months to 84.1 \u00b1 4.9 at 12 months (p &lt; 0.001). Audiometric evaluation demonstrated a significant postoperative improvement, with the mean air\u2013bone gap (ABG) decreasing from 52.1 \u00b1 5.3 dB preoperatively to 26.4 \u00b1 4.7 dB postoperatively (p &lt; 0.001), indicating substantial closure of the conductive gap. Conclusions: Exclusive endoscopic cholesteatoma surgery yields robust QoL improvement, favourable hearing outcome, and recurrence rates similar to classic techniques at short-term evaluation.<\/jats:p>","DOI":"10.3390\/jcm15041556","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T08:38:39Z","timestamp":1771231119000},"page":"1556","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of Life Outcomes After Endoscopic Cholesteatoma Surgery: A Prospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5250-9219","authenticated-orcid":false,"given":"Luana-Maria","family":"Gherasie","sequence":"first","affiliation":[{"name":"General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cProf. Dr. D. Hociota\u201d Institute of Phonoaudiology and Functional ENT Surgery, 050751 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viorel","family":"Zainea","sequence":"additional","affiliation":[{"name":"General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cProf. Dr. D. Hociota\u201d Institute of Phonoaudiology and Functional ENT Surgery, 050751 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamer","family":"Ebaied","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat, Sheikh Shakhbout Medical City (SSMC), Abu Dhabi 11001, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Razvan","family":"Hainarosie","sequence":"additional","affiliation":[{"name":"General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cProf. Dr. D. Hociota\u201d Institute of Phonoaudiology and Functional ENT Surgery, 050751 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corina Daniela","family":"Negrila","sequence":"additional","affiliation":[{"name":"General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cProf. Dr. D. Hociota\u201d Institute of Phonoaudiology and Functional ENT Surgery, 050751 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea","family":"Rusescu","sequence":"additional","affiliation":[{"name":"General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cProf. Dr. D. Hociota\u201d Institute of Phonoaudiology and Functional ENT Surgery, 050751 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina-Gabriela","family":"Ionita","sequence":"additional","affiliation":[{"name":"General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cProf. Dr. D. Hociota\u201d Institute of Phonoaudiology and Functional ENT Surgery, 050751 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalina","family":"Voiosu","sequence":"additional","affiliation":[{"name":"General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cProf. Dr. D. Hociota\u201d Institute of Phonoaudiology and Functional ENT Surgery, 050751 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1080\/00016489950180801","article-title":"Epidemiology and Aetiology of Middle Ear Cholesteatoma","volume":"119","author":"Kemppainen","year":"1999","journal-title":"Acta Otolaryngol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s12105-018-0915-5","article-title":"Cholesteatoma Pearls: Practical Points and Update","volume":"12","author":"Castle","year":"2018","journal-title":"Head Neck Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1097\/MAO.0000000000002845","article-title":"Multinational Appraisal of the Chronic Otitis Media Questionnaire 12 (COMQ-12)","volume":"42","author":"Phillips","year":"2021","journal-title":"Otol. Neurotol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2275","DOI":"10.1007\/s00405-024-09097-8","article-title":"Health-Related Quality of Life in Patients after Endoscopic or Microscopic Cholesteatoma Surgery","volume":"282","author":"Raemy","year":"2024","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"396","DOI":"10.5152\/iao.2019.7266","article-title":"Health Related Quality of Life after the Bony Obliteration Tympanoplasty for COM with Cholesteatoma Using the COMQ12-A Disease Specific PROM","volume":"15","author":"Baetens","year":"2019","journal-title":"J. Int. Adv. Otol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1177\/0003489414523562","article-title":"Quality of Life after Cholesteatoma Surgery: Intact-Canal Wall Tympanoplasty versus Canal Wall-down Tympanoplasty with Mastoid Obliteration","volume":"123","author":"Quaranta","year":"2014","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2729","DOI":"10.1007\/s00405-020-06002-x","article-title":"Mapping the ChOLE Classification to Hearing Outcomes and Disease-Specific Health-Related Quality of Life","volume":"277","author":"Weiss","year":"2020","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_8","first-page":"1365","article-title":"Evaluating Hearing Outcome, Recidivism and Complications in Cholesteatoma Surgery Using the ChOLE Classification System","volume":"278","author":"Rrahmani","year":"2020","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.lers.2021.01.004","article-title":"Endoscopic Ear Surgery in Middle Ear Cholesteatoma","volume":"4","author":"Nair","year":"2021","journal-title":"Laparosc. Endosc. Robot. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5152\/iao.2017.3363","article-title":"EAONO\/JOS Joint Consensus Statements on the Definitions, Classification and Staging of Middle Ear Cholesteatoma","volume":"13","author":"Yung","year":"2017","journal-title":"J. Int. Adv. Otol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/MAO.0000000000002039","article-title":"Introducing the \u201cChOLE\u201d Classification and Its Comparison to the EAONO\/JOS Consensus Classification for Cholesteatoma Staging","volume":"40","author":"Linder","year":"2019","journal-title":"Otol. Neurotol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"109872","DOI":"10.1016\/j.ijporl.2020.109872","article-title":"Can Endoscopic Ear Surgery Replace Microscopic Surgery in the Treatment of Acquired Cholesteatoma? A Contemporary Review","volume":"131","author":"Hu","year":"2020","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.otc.2012.10.001","article-title":"Transcanal Endoscopic Management of Cholesteatoma","volume":"46","author":"Tarabichi","year":"2013","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s40136-022-00424-3","article-title":"Endoscopic Ear Surgery: Past and Future","volume":"10","author":"Bonali","year":"2022","journal-title":"Curr. Otorhinolaryngol. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s00405-019-05688-y","article-title":"Endoscopic Stapedotomy: Safety and Audiological Results in 150 Patients","volume":"277","author":"Bianconi","year":"2020","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ejenta.2012.02.007","article-title":"Histopathological and Immunohistochemical Characteristics of Acquired Cholesteatoma in Children and Adults","volume":"13","author":"Bassiouny","year":"2012","journal-title":"Egypt. J. Ear Nose Throat Allied Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"775","DOI":"10.47162\/RJME.65.4.24","article-title":"Biology of Recurrent Cholesteatoma in a Romanian Young Patient\u2014A Case Report","volume":"65","author":"Bologa","year":"2024","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/S1808-8694(15)31250-7","article-title":"Correlation of Cholesteatomas Perimatrix Thickness with Patient\u2019s Age","volume":"71","author":"Dornelles","year":"2005","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_19","unstructured":"Kennedy, K.L., and Singh, A.K. (2024). Middle Ear Cholesteatoma. StatPearls, StatPearls Publishing."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., G\u00f8tzsche, P.C., and Vandenbroucke, J.P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040296"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1097\/MAO.0000000000000205","article-title":"A new health-related quality of life measure for active chronic otitis media (COMQ-12): Development and initial validation","volume":"35","author":"Phillips","year":"2014","journal-title":"Otol. Neurotol."},{"key":"ref_22","unstructured":"(2025, August 23). Glasgow Health Status Questionnaires Manual. Available online: https:\/\/studylib.net\/doc\/8450311\/the-health-status-questionnaires-manual."},{"key":"ref_23","unstructured":"(2025, August 23). Quality of Life After Cholesteatoma Surgery: Comparison Between Surgical Techniques.\u2014Abstract\u2014Europe PMC. Available online: https:\/\/europepmc.org\/article\/PMC\/9330745."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"E1507","DOI":"10.1097\/MAO.0000000000003299","article-title":"Impact of Hearing Disability and Ear Discharge on Quality-of-Life in Patients with Chronic Otitis Media: Data from the Multinational Collaborative COMQ-12 Study","volume":"42","author":"Phillips","year":"2021","journal-title":"Otol. Neurotol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/S0194-59980301577-8","article-title":"Endoscope Affects Decision Making in Cholesteatoma Surgery","volume":"129","author":"Mandour","year":"2003","journal-title":"Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e468","DOI":"10.1097\/MAO.0000000000002549","article-title":"A Retrospective Analysis and Comparison of the STAM and STAMCO Classification and EAONO\/JOS Cholesteatoma Staging System in Predicting Surgical Treatment Outcomes of Middle Ear Cholesteatoma","volume":"41","author":"Janssen","year":"2020","journal-title":"Otol. Neurotol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3777","DOI":"10.1007\/s00405-020-06478-7","article-title":"Practical Applicability of the STAMCO and ChOLE Classification in Cholesteatoma Care","volume":"278","author":"Merkus","year":"2021","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1001\/jamaoto.2022.4660","article-title":"Outcomes of Endoscopic Congenital Cholesteatoma Removal in South Korea","volume":"149","author":"Choi","year":"2023","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40463-016-0117-7","article-title":"Endoscopic Ear Surgery in Canada: A Cross-Sectional Study","volume":"45","author":"Yong","year":"2016","journal-title":"J. Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.otc.2012.10.007","article-title":"Instrumentation and Technologies in Endoscopic Ear Surgery","volume":"46","author":"James","year":"2013","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"225","DOI":"10.5152\/iao.2024.231122","article-title":"Efficacy of Otoendoscopy for Residual Cholesteatoma Detection During Microscopic Chronic Ear Surgery","volume":"20","author":"Couvreur","year":"2024","journal-title":"J. Int. Adv. Otol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1097\/00129492-200209000-00004","article-title":"Value of Ear Endoscopy in Cholesteatoma Surgery","volume":"23","year":"2002","journal-title":"Otol. Neurotol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"T\u0103nase, N.V., Hain\u0103ro\u0219ie, R., Br\u00eendu\u0219e, L.A., Corneci, D., Voiosu, C., Rusescu, A., Cobilinschi, C., Stanciu G\u0103van, C., and Zainea, V. (2025). A Clinical Comparative Study of Schnider and Eleveld Pharmacokinetic\u2013Pharmacodynamic Models for Propofol Target-Controlled Infusion Sedation in Drug-Induced Sleep Endoscopy. Biomedicines, 13.","DOI":"10.3390\/biomedicines13040822"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"217","DOI":"10.4329\/wjr.v9.i5.217","article-title":"Diffusion Weighted Imaging for the Detection and Evaluation of Cholesteatoma","volume":"9","author":"Henninger","year":"2017","journal-title":"World J. Radiol."},{"key":"ref_35","first-page":"53","article-title":"Value of Echo-Planar Diffusion-Weighted Magnetic Resonance Imaging for Detecting Tympanomastoid Cholesteatoma","volume":"11","year":"2015","journal-title":"J. Int. Adv. Otol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/coa.13459","article-title":"Endoscopic Ear Surgery: Does It Have an Impact on Quality of Life? Our Experience of 152 Cases","volume":"45","author":"Taneja","year":"2020","journal-title":"Clin. Otolaryngol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.anorl.2019.03.005","article-title":"Endoscopic Classification of the External Auditory Canal for Transcanal Endoscopic Ear Surgery","volume":"136","author":"Ayache","year":"2019","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1017\/S0022215118000695","article-title":"Preliminary Outcomes of Endoscopic Middle-Ear Surgery in 103 Cases: A UK Experience","volume":"132","author":"Yiannakis","year":"2018","journal-title":"J. Laryngol. Otol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1007\/s12070-017-1084-7","article-title":"Outcomes of Using Otoendoscopy During Surgery for Cholesteatoma","volume":"71","author":"Elfeky","year":"2019","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1017\/S0022215107009346","article-title":"Combined Approach Tympanoplasty for Cholesteatoma: Impact of Middle-Ear Endoscopy","volume":"122","author":"Barakate","year":"2008","journal-title":"J. Laryngol. Otol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1097\/MAO.0b013e318188e8d7","article-title":"Otoendoscopy in Cholesteatoma Surgery of the Middle Ear: What Benefits Can Be Expected?","volume":"29","author":"Ayache","year":"2008","journal-title":"Otol. Neurotol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.joto.2020.06.004","article-title":"Role of Endoscopy in Surgical Management of Cholesteatoma: A Systematic Review","volume":"15","author":"Verma","year":"2020","journal-title":"J. Otol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1177\/0194599815622441","article-title":"Long-Term Results of Endoscopically Assisted Pediatric Cholesteatoma Surgery","volume":"154","author":"Sarcu","year":"2016","journal-title":"Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"102451","DOI":"10.1016\/j.amjoto.2020.102451","article-title":"Endoscopic versus Microscopic Surgery for Treatment of Middle Ear Cholesteatoma: A Systematic Review and Meta-Analysis","volume":"42","author":"Li","year":"2021","journal-title":"Am. J. Otolaryngol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/MAO.0000000000002876","article-title":"Systematic Review of Endoscopic Ear Surgery Outcomes for Pediatric Cholesteatoma","volume":"42","author":"Basonbul","year":"2021","journal-title":"Otol. Neurotol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/s43163-023-00492-2","article-title":"Comparison of the Outcomes of Endoscopic versus Microscopic Approach in Cholesteatoma Surgery: A Randomized Clinical Study","volume":"39","author":"Hamela","year":"2023","journal-title":"Egypt. J. Otolaryngol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/MAO.0b013e3182096b39","article-title":"Exclusive Endoscopic Ear Surgery for Acquired Cholesteatoma: Preliminary Results","volume":"32","author":"Migirov","year":"2011","journal-title":"Otol. Neurotol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1177\/0194599817729136","article-title":"Residual Cholesteatoma during Second-Look Procedures Following Primary Pediatric Endoscopic Ear Surgery","volume":"157","author":"Cohen","year":"2017","journal-title":"Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"156","DOI":"10.21053\/ceo.2018.00507","article-title":"Comparison of the Clinical Results of Attic Cholesteatoma Treatment: Endoscopic versus Microscopic Ear Surgery","volume":"12","author":"Bae","year":"2019","journal-title":"Clin. Exp. Otorhinolaryngol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.otc.2012.10.007","article-title":"Endoscopic Middle Ear Surgery in Children","volume":"46","author":"James","year":"2013","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1097\/00005537-200407000-00005","article-title":"Endoscopic Management of Limited Attic Cholesteatoma","volume":"114","author":"Tarabichi","year":"2004","journal-title":"Laryngoscope"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Otsuka, A., Koyama, H., Kashio, A., Matsumoto, Y., and Yamasoba, T. (2024). Comparison of Endoscopic and Microscopic Surgery for the Treatment of Acquired Cholesteatoma by EAONO\/JOS Staging. Healthcare, 12.","DOI":"10.3390\/healthcare12171737"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.otc.2020.09.014","article-title":"Endoscopic Management of Primary Acquired Cholesteatoma","volume":"54","author":"Chiao","year":"2021","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_54","first-page":"1","article-title":"Total Transcanal Endoscopic Ear Surgery for Cholesteatoma","volume":"61","author":"Zorlu","year":"2023","journal-title":"Turk. Arch. Otorhinolaryngol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1002\/lary.20995","article-title":"Inferior Retrotympanum Revisited: An Endoscopic Anatomic Study","volume":"120","author":"Marchioni","year":"2010","journal-title":"Laryngoscope"},{"key":"ref_56","first-page":"854024","article-title":"Updates and Knowledge Gaps in Cholesteatoma Research","volume":"2015","author":"Kuo","year":"2015","journal-title":"Biom. Res. Int."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.ijporl.2014.12.008","article-title":"Endoscopic Exclusive Transcanal Approach to the Tympanic Cavity Cholesteatoma in Pediatric Patients: Our Experience","volume":"79","author":"Marchioni","year":"2015","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_58","unstructured":"(2025, August 23). The Efficacy of Transcanal Endoscopic Ear Surgery in Children Compared to Adults\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/40310232\/."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/MOO.0b013e32836464bd","article-title":"Management of Acquired Cholesteatoma in the Pediatric Population","volume":"21","author":"Dornhoffer","year":"2013","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"3601","DOI":"10.1007\/s00405-014-3291-0","article-title":"A Review of Current Progress in Acquired Cholesteatoma Management","volume":"272","author":"Kuo","year":"2015","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.1016\/j.ijporl.2015.10.019","article-title":"Transcanal Endoscopic Ear Surgery for Pediatric Population with a Narrow External Auditory Canal","volume":"79","author":"Ito","year":"2015","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/j.otc.2019.06.001","article-title":"Principles of Pediatric Endoscopic Ear Surgery","volume":"52","author":"Miller","year":"2019","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1001\/jamaoto.2020.0001","article-title":"Evaluation of Residual Disease Following Transcanal Totally Endoscopic vs Postauricular Surgery among Children with Middle Ear and Attic Cholesteatoma","volume":"146","author":"Dixon","year":"2020","journal-title":"JAMA Otolaryngol. 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