Zorlu, Mehmet EkremYaramis, BerkCeylan, Mehmet EmrahDalgic, Abdullah2025-03-202025-03-2020241308-76492148-3817https://doi.org/10.5152/iao.2024.231405https://hdl.handle.net/20.500.14034/2198BACKGROUND:This This study aimed to compare total endoscopic ear surgery (TEES) and microscopic postauricular canal-wall-down tympanomastoidectomy (CWD) in cholesteatoma surgery in our clinic. METHODS: This study included 59 patients, of whom 30 and 29 were operated on with CWD in 2016-2018 and TEES in 2019-2021, respectively and compared regarding intraoperative findings, hearing outcomes, long-term outcomes, and recidivism rates between groups. This study excluded patients in stage IV according to the European Academy of Otology and Neurotology/Japan Otological Society Staging System on Middle Ear Cholesteatoma, aged < 18, with congenital cholesteatoma, who underwent revision surgery. RESULTS: Two patients in the TEES group had recidivism (6.9%), with recurrent disease observed in both patients and residual disease in none, whereas 3 patients in the CWD group had recidivism (10%), including recurrent disease in 2 and residual disease in 1 patient. Tympanic membrane perforation occurred in 2 (6.9%) and 1 (3.3%) patients in the TEES and CWD groups, respectively. The 2 groups revealed no significant difference in terms of recidivism and perforation rates (P = 1.000, P = .612). The CWD group had a longer mean operation time (225.54 +/- 47.86 minutes) than the TEES group (160.55 +/- 24.98 minutes) (P < .001). The 2 groups demonstrated no significant difference regarding pre- and postoperative air-bone gap (ABG) and ABG gain (P = .105, P = .329, P = .82, respectively). CONCLUSION: Total endoscopic ear surgery provides similar results in terms of hearing, recidivism, and long-term outcomes with the microscopic CWD approach. However, the CWD approach is still important, especially in patients in advanced stages.eninfo:eu-repo/semantics/openAccessCholesteatomacanal-wall-downendoscopic ear surgeryArticle10.5152/iao.2024.231405204Q3WOS:0013419323000052-s2.0-8520155958439161175Q3