Surgery by Dr. Miguel Arístegui and Dr. José Carlos Casqueiro
At online surgery app SurgSchool, we have incorporated a new cholesteatoma surgery with a microscopic-endoscopic approach performed by the Dr. Miguel Arístegui and the Dr. José Carlos Casqueiro, both Spanish otorhinolaryngologists located in Madrid.
Cholesteatoma surgery remains one of the greatest challenges in otology, especially in advanced or atypical cases. Complex mesotympanic cholesteatoma requires detailed assessment and a precise surgical approach to achieve complete resection without compromising critical anatomical structures. In this setting, the combination of microscopic and endoscopic approaches allows for enhanced visualization and better access to hidden corners of the middle ear.
Details of the surgical procedure
In this intervention, the Dr. Miguel Arístegui and the Dr. José Carlos Casqueiro They performed a complete resection of a complex mesotympanic cholesteatoma using a combined microscopic and endoscopic approach.
Stages of surgery:
- Initial evaluation and dissection under microscopic vision: Resection is initiated using conventional microsurgical techniques, accessing the tympanic cavity and assessing the extent of the cholesteatoma.
- Use of otological endoscopy: As difficult-to-access recesses (such as the facial or hypotympanic recess) are identified, the endoscope is introduced for a wider and more detailed view.
- Complete resection of cholesteatoma: Thanks to the synergy of both approaches, the complete elimination of pathological tissue is achieved, minimizing the risk of residue or recurrence.
- Tympanic reconstruction: Once the lesion is removed, myringoplasty is performed to preserve or restore the patient's hearing function.
Advantages of the combined approach
- Three-dimensional visualization: The microscope provides depth, while the endoscope allows you to observe hidden areas.
- More complete resection: The possibility of residual cholesteatoma, the main cause of recurrence, is reduced.
- Preservation of noble structures: Facilitates more precise dissection around the ossicular chain, facial nerve and other structures.
Conclusion
This case exemplifies the high level of precision achieved through the combined use of microscopic and endoscopic technology in advanced otologic surgery. The collaboration between Dr. Miguel Arístegui and Dr. José Carlos Casqueiro provides an optimal and up-to-date approach for the resection of complex cholesteatomas.
Available in video on the platform SurgSchool: Otologic surgery as a reference for specialists.
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