OBJECTIVE: Routine endoscopic examination during primary surgery decreased the rate of residual @entity3540 to 18% in our early experience. Based on this, we stopped performing routine second-look surgery in @entity1 who were endoscopically free of @entity3540 at the end of primary surgery. We sought to investigate if second-look procedures after endoscopic-assisted surgery could safely be performed only in @entity1 at a high risk of @entity66 (extensive @entity32 , spontaneously @entity397 or fragmented @entity3540 , @entity66 intentionally left). STUDY DESIGN: Case series with chart review. SETTING: Tertiary pediatric otolaryngology practice. SUBJECTS AND METHODS: @entity1 aged 1 to 16 years who were treated for @entity3540 over 15-year period by a single surgeon. Extent of disease and endoscopic findings were compared with rates of @entity66 . Time to diagnosis of @entity66 and prognostic factors were analyzed. RESULTS: Forty-two @entity1 underwent endoscopically assisted middle ear surgery for @entity3540 . Of 42 @entity1 , 7 (17%) had additional disease found by endoscopy that was missed by microscopy alone. Twelve @entity1 at high risk had second looks; 5 (42%) had @entity66 . Of 30 @entity1 , 2 (7%) presented with macroscopically evident residual @entity3540 after no planned second look on office follow-up and subsequently underwent reoperation and were cured. CONCLUSIONS: Selective second-look surgery in high-risk @entity1 did not adversely affect outcome as compared with the low-risk group. @entity3540 was identified endoscopically in 7 of 42 (17%) @entity1 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.

Long-term Results of Endoscopically Assisted Pediatric XXXX Surgery.

@entity1 :: ('9606', 'Species') :: ['children', 'Children'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity66 :: ('MESH:D004194', 'Disease') :: ['residual disease'] @entity3540 :: ('MESH:D002781', 'Disease') :: ['cholesteatoma', 'Cholesteatoma'] @entity397 :: ('MESH:D012421', 'Disease') :: ['ruptured']
@entity3540 :: (MESH:D002781,Disease) :: ['Cholesteatoma']
