The endoscope allows minimally invasive  access through the natural ear canal, rather than through the usual 5 cm incision behind the ear utilized in traditional microscopic surgery. The 30 degrees endoscope allows access to the bony area of the Eustachian tube to address any obstructive pathologies. Prognosis
It is important that the patient attend periodic follow-up checks, because even after careful microscopic surgical removal, cholesteatomas may recur. Such recurrence may arise many years, or even decades, after treatment. A residual cholesteatoma may develop if the initial surgery failed to completely remove the original; residual cholesteatomas typically become evident within the first few years after the initial surgery. A recurrent cholesteatoma is a new cholesteatoma that develops when the underlying causes of the initial cholesteatoma are still present. Such causes can include, for example, poor Eustachian tube function, which results in retraction of the ear drum, and failure of the normal outward migration of skin.In a retrospective study of 345 patients with middle ear cholesteatoma operated on by the same surgeon, the overall 5-year recurrence rate was 11.8%. In a different study with a mean follow-up period of 7.3 years, the recurrence rate was 12.3%, with the recurrence rate being higher in children than in adults. The use of the endoscope as an ancillary instrument has been shown to reduce the incidence of residual cholesteatoma.
Celecoxib/tramadol sold under the brand name Seglentis, is a fixed-dose combination of the anti-inflammatory celecoxib and the opioid tramadol used for the management and treatment of pain.Developed by Spanish pharmaceutical company Esteve, it was approved for medical use in the United States in October 2021. References
External links
"Celecoxib". Drug Information Portal. U.S. National Library of Medicine. "Tramadol hydrochloride". Drug Information Portal. U.S. National Library of Medicine. Clinical trial number NCT03108482 for "Co-crystal E-58425 vs Tramadol and Celecoxib for Moderate to Severe Acute Pain After Bunionectomy. Phase III Clinical Trial." at ClinicalTrials.gov