• Ryosei Minoda and Toru Miwa.
• Middle Ear and Inner Ear Surgical Center, Japan Community Health Care Organization Kumamoto General Hospital, Kumamoto, Japan.
• Otol. Neurotol. 2019 Jul 1; 40 (6): 777-781.

ObjectiveTo assess the feasibility of a postauricular transcortical mastoidectomy utilizing an exoscope, which offers 3D stereoscopic visualization.Study DesignClinical capsule report.PatientsTwo consecutive patients with cholesteatoma involvement in the mastoid cavity were included in the study.InterventionAfter transcanal endoscopic surgery, postauricular mastoidectomy utilizing a surgical 3D exoscope was performed. Then, the cholesteatoma in the mastoid cavity was removed through the mastoidectomy opening with endoscopes.ResultsThe postauricular transcortical mastoidectomy utilizing a 3D exoscope was not only feasible, but importantly, the exoscope took little time to switch to and resulted in a smooth workflow. There was no cholesteatoma recurrence at 9 months.ConclusionDuring endoscope-based surgery, in patients with cholesteatoma mastoid involvement, we can continue to perform the surgical procedure in a heads-up position utilizing a surgical 3D exoscope. The combination of transcanal endoscopic ear surgery and the postauricular transcortical mastoidectomy utilizing a surgical 3D exoscope is a very novel treatment strategy for cholesteatoma, and it gives us a comfortable and consistent working environment in endoscope-based ear surgery.

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