Abstract:Objective To explore the feasibility of treatment of middle ear cholesteatoma in young children with transcanal totally endoscopic ear surgery, and to guide the path of clinical diagnosis and treatment. Methods The young children (≤ 6 years old) with middle ear cholesteatoma who were treated by surgery via transcanal totally endoscopic in our department from April 2016 to March 2021 were selected as the object of study. The general data, degree of the lesion, intraoperative condition, postoperative complications, hospital stays, and recurrence were statistically analyzed. To analyze the feasibility and strategy of total ear canal endoscopic surgery in young children. Results There were 26 children in the group, the age was 4.1±0.9 years old, and the youngest was 1.9 years old. There were 19 boys (73.1%) and 7 girls (26.9%). There were 21 cases of congenital cholesteatoma (80.8%) and 5 cases of acquired cholesteatoma (19.2%). According to EAONO/JOS staging, there were 7 cases of stage I (26.9%), 18 cases of stage II (69.2%), 1 case of stage III (3.8%), and 0 cases of stage IV. Multi-angle oto-endoscopes were used in 12 cases. The intraoperative bleeding was 1.0(1.0, 2.0) ml. The length of operation was 85.0(50.0, 110.0) minutes, and the postoperative hospital stay was 2.0(2.0, 5.0)days. After an operation, 3 cases had short-term vertigo, 1 case had temporary mild facial movement asymmetry, and no other complications were found. Recurrence occurred in 1 case. Conclusion Total endoscopic otologic surgery can be performed for middle ear cholesteatoma in young children. The extension of cholesteatoma to the posterior tympanic, epitympanum, and the entrance of the tympanic sinus should be observed with the aid of multi-angle oto-endoscopes. Ear endoscope has obvious advantages in the observation of fine structure, which can effectively protect the structure of the middle ear.