09-11, 11:45–12:45 (Europe/Istanbul), Otology 2 (ICC - B2 Floor - Beylerbeyi 1)
Title: Transcanal Endoscopic Cholesteatoma Surgery: Advantages, Limitations, and Pushing the Technical Boundaries
Objective: Transcanal Endoscopic Ear Surgery (TEES) has revolutionized the management of middle ear cholesteatoma by offering unprecedented access to hidden recesses. This presentation aims to evaluate the clinical advantages, inherent drawbacks, and technical limitations of exclusive endoscopic cholesteatoma surgery, while highlighting contemporary boundary-pushing techniques that expand its indications in complex cases.
Methods: The surgical principles and clinical outcomes of TEES in cholesteatoma eradication were systematically analyzed. The focus was placed on the direct visualization of critical areas such as the sinus tympani, facial recess, and anterior epitympanum. Additionally, the presentation reviews advanced technical solutions—including customized structural graft modifications and modified attic reconstructions—designed to overcome traditional endoscopic constraints and prevent retraction pockets.
Results: The primary advantage of TEES in cholesteatoma treatment is its superior, wide-angle panoramic visualization, which facilitates complete disease eradication from deep recesses without the morbidity of extensive canalplasty or retroauricular mastoidectomy. This minimally invasive transcanal approach significantly reduces postoperative pain and ensures excellent cosmetic outcomes. However, the loss of binocular depth perception and the strict requirement for one-handed surgery remain major drawbacks, particularly during active bleeding. While narrow pediatric external auditory canals traditionally limit instrument maneuverability, contemporary boundary-pushing innovations—such as the utilization of highly pliable, customized annular chondroperichondrial grafts—successfully overcome structural limitations, preventing post-operative retractions while facilitating single-handed graft management even in complex reconstructions.
Conclusion: TEES is a highly effective, minimally invasive alternative that offers unmatched visualization for complete cholesteatoma eradication. While the one-handed learning curve demands structured training, this presentation underlines that understanding technical limits, while actively implementing innovations that push these boundaries, is paramount for expanding patient selection and achieving long-term surgical success without recurrence.
He graduated from the Medical Faculty of Aegean University in 1989 and completed his residency in Otolaryngology at İzmir Atatürk Education and Research Hospital in 1994. Following this, he spent a year as a research fellow in the Department of Otolaryngology at the University of Pittsburgh. In 1997, he received his first academic appointment at Pamukkale University. He is affiliated with several professional organizations, including the Turkish Otolaryngology and Head and Neck Surgery Association, the European Academy of Otology and Neurotology, the Neurotological and Equilibriometric Society, and the Mediterranean Society of Otology and Audiology. He has authored numerous articles, book chapters, and books in both Turkish and English, primarily focused on Otology and Neurotology. In recent years, his research has centered on hearing reconstruction, implants, endoscopic ear surgery, vestibular disorders, and vestibular rehabilitation.
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Professor of Otolaryngology, ENT Department, Faculty of Medicine, Alexandria University, EGYPT.
Senior Consultant Otology, Neurotology, Skull Base Surgery.
Past-President and founding member of the International Working Group on Endoscopic Ear Surgery (IWGEES)
President of the Egyptian Society of Skull Base Surgery; Egypt (ESSBS)
Member of the American Academy of Otolaryngology-Head and Neck Surgery (AAOHNS) - USA.
Member of the French Society of Otorhinolaryngology; France.
Member of the Association for Research in Otolaryngology (ARO), U.S.A.
Member of the Prosper Meniere's Society; Colorado, U.S.A.
Professor of Otolaryngology, ENT Department, Faculty of Medicine, Alexandria University, EGYPT.
Senior Consultant Otology, Neurotology, Skull Base Surgery.
Past-President and founding member of the International Working Group on Endoscopic Ear Surgery (IWGEES)
President of the Egyptian Society of Skull Base Surgery; Egypt (ESSBS)
Member of the American Academy of Otolaryngology-Head and Neck Surgery (AAOHNS) - USA.
Member of the French Society of Otorhinolaryngology; France.
Member of the Association for Research in Otolaryngology (ARO), U.S.A.
Member of the Prosper Meniere's Society; Colorado, U.S.A
Jong Woo Chung, MD, is a professor and former chairman of the Department of Otorhinolaryngology-Head and Neck Surgery at Asan Medical Center, University of Ulsan College of Medicine. Dr. Chung and his colleagues lead multiple clinical research projects focusing on sensorineural hearing loss, cochlear implantation, middle ear implants, chronic ear disease, and pediatric otitis media. His recent research interests have expanded into robotic-assisted ear surgery, artificial intelligence applications in otology, and endoscopic ear surgery.
Dr. Chung earned his medical degree from Seoul National University College of Medicine, where he also completed his residency and Ph.D. training in Otolaryngology. Following advanced training in general otology, neurotology, skull base surgery, and cochlear implantation, he joined Asan Medical Center, where he further developed programs in skull base surgery, audiology, endoscopic ear surgery, and cochlear implantation. He also initiated basic research on noise-induced hearing loss.
Dr. Chung has published over 130 peer-reviewed articles indexed in SCI/SCIE journals. He has held numerous leadership roles, including President of the Korean Audiological Society (2014–2016), President of the Korean Skull Base Society (2017), and President of the Korean Association of Institutional Review Boards (2020–2023). He currently serves as President of the upcoming World Congress of Audiology 2026, which will be held in Seoul.
- Temporal Bone Paraganglioma Resection Through Endoscopic Transcanal Approach: Video Illustration Of Critical Surgical Points
- Management Of Temporal Bone And External Auditory Canal Tumors
- Outcomes Of The Canal Wall Down Mastoidectomy In The Management Of Middle Ear Cholesteatoma
- The Management Of Advanced Malignancies In The External Auditory Canal And Temporal Bone
- Reimagining Otologic Practice Through Technology
- Tympanojugular Paraganglioma: Our Experience Of 46 Cases
- Endoscopic Ear Surgery
- Endoscopic Management Of Attic Cholesteatoma
- Canal Wall Down Tympanoplasty With Mastoid Obliteration Using Bone Pate Plate For Canal Wall Reconstruction In Cholesteatoma Surgery
- APSCI Board Panel
- Difficult CI Surgery
- Stapedectomy In Patients With Dehiscent And Prolapsed Facial Nerve
- Facial Nerve Reanimation
- Cholesteatoma Surgery: A Visual Review Of Endoscopic And Microscopic Surgical Techniques
Dr. Mehmet Murat Günay is an ENT specialist at Ankara Etlik City Hospital, with a focus on otologic and reconstructive ear surgery. He completed his residency at the University of Health Sciences, Dışkapı Yıldırım Beyazıt ENT Clinic. With over 10 years of clinical experience, he has published extensively in international journals and presented at numerous national and international congresses. He is also an instructor in cadaver dissection courses and holds certifications in sleep medicine and otology-neurotology. His current clinical research focuses on improving surgical outcomes in otoplasty and cochlear implantation.
Daniele BERNARDESCHI, MD, PhD
Born 5 July 1974 - Rome – Italy
Married, 4 children
Hospital:
ENT Department– Hôpital Pitié Salpétrière - 47-83, boulevard de l'Hôpital - 75013 Paris- France
Email: [email protected]
Present position :
· Surgeon at ENT Department, Unité Otology, Auditory Implant, Skull base surgery, Hôpital Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris
Titles :
· MD (Università di Roma « La Sapienza »), (1999)
· ENT Residency (Università di Roma « La Sapienza »), (2003)
· PhD in Neurosurgery and (Università di Roma « La Sapienza »), (2009)
Cursus :
· ENT Italian residency (1999-2003)
· ENT French residency (2003-2006)
· PhD in Rome (2006-2009)
· ENT and skull base surgeon at Beaujon Hospital – Paris - France (2008-2013)
1991)
· ENT and skull base surgeon at Pitié-Salpetriere Hospital – Paris - France (2013- )
Member of :
· Société Française d'Oto-Rhino-Laryngologie et de Pathologie de la face et du cou (2005-)
· Società italiana di otorinolaringoiatria e chirurgia cervico-facciale) (2003-2012)
· European Academy of Otology and Neuro-Otology (2003-)
· Politzer Society (2012-)
Publications: 86 articles indexed in PUBMED
Prof. Dr. Semsettin Okuyucu is an ENT Professor at Medicana International Ankara Hospital with a strong clinical focus on Transcanal Endoscopic Ear Surgery (TEES). A graduate of Cerrahpasa Faculty of Medicine (English Program), his academic career includes serving as a senior faculty member at Hatay Mustafa Kemal University (2004–2023). He has completed advanced fellowships at Johns Hopkins University, University of Pittsburgh, University of Florida, and the University of Rome. As an active member of the Turkish Society of Otology and Neurotology and the Endoscopic Ear Surgery Working Group, his work is dedicated to utilizing the limits of TEES. An invited speaker at premier global symposia, his clinical TEES presentations and customized graft innovations have been featured at the prestigious Politzer Society meetings and APSCI, contributing to the advancement of minimally invasive hearing reconstruction.