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Cholesteatoma

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2. Cholesteatoma

Cholesteatoma Cholesteatoma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cholesteatoma Last reviewed: February 2019 Last updated: January 2018 Summary Accumulation of squamous epithelium and keratin debris that usually involves the middle ear and mastoid. Although benign, it may enlarge and invade adjacent bone. Often presents with a malodorous ear discharge with associated hearing loss. Diagnosis is clinical (...) based on history and otoscopic findings. CT scan provides lesion definition and extent. Treatment is surgical removal. Adjunctive topical antimicrobial treatment may help reduce acute symptoms preoperatively. Complications include recurrence, meningitis, facial palsy, and a labyrinthine fistula. Definition Cholesteatoma is defined as the presence of keratinising squamous epithelium within the middle ear, or in other pneumatised areas of the temporal bone. Fisch U, May JS, Linder T. Mastoidectomy

2018 BMJ Best Practice

3. The Role of Non-Echoplanar Diffusion-Weighted Magnetic Resonance Imaging in Diagnosis of Primary Cholesteatoma and Cholesteatoma Recidivism as an Adjunct to Clinical Evaluation. (PubMed)

The Role of Non-Echoplanar Diffusion-Weighted Magnetic Resonance Imaging in Diagnosis of Primary Cholesteatoma and Cholesteatoma Recidivism as an Adjunct to Clinical Evaluation. The aim of this study was to analyze the sensitivity and specificity of non-echoplanar (non-EPI) diffusion-weighted (DW) magnetic resonance imaging (MRI) for the detection of cholesteatoma, with a focus on its value as an adjunct to clinical examination.In a prospective cohort study, 92 cases were divided into 2 groups (...) : "clinically cholesteatoma" ( n = 79) and "clinically no cholesteatoma" ( n = 13). Non-EPI DW MRI was performed preoperatively in all cases. The presence of a cholesteatoma was assessed by clinicians otoscopically, by neuroradiologists on non-EPI DW MRI, by the surgeon intraoperatively, and finally by the pathologist postoperatively. Data analysis was performed for specificity, sensitivity, positive predictive value, negative predictive value, and interrater variability.The sensitivity and specificity were

2018 Rhinology and Laryngology

4. Outpatient management of cholesteatoma with canal wall reconstruction tympanomastoidectomy (PubMed)

Outpatient management of cholesteatoma with canal wall reconstruction tympanomastoidectomy The postoperative wound infection rate for canal wall reconstruction (CWR) tympanomastoidectomy with mastoid obliteration in the treatment of chronic otitis media with cholesteatoma has been reported to be 3.6%. Postoperative administration of 24-48 hours of intravenous antibiotics has been recommended. We aim to determine the infection rate of CWR with postoperative outpatient oral

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2017 Laryngoscope investigative otolaryngology

5. Endoscopic transcanal modified canal-wall-down mastoidectomy for cholesteatoma (PubMed)

Endoscopic transcanal modified canal-wall-down mastoidectomy for cholesteatoma Attic cholesteatoma with antral extension in tight sclerotic mastoid cavities is a common presentation that creates difficult decision-making intraoperatively. Drilling through a sclerotic and small mastoid cavity, keeping the canal wall intactis often difficult and increases the risk of serious injury. Consequently, a canal-wall-down mastoidectomy is often performed. The endoscopic transcanal modified canal-wall (...) -down mastoidectomy approach allows the benefits of an open cavity for cholesteatoma resection and the benefits of a closed cavity for better long-term care and a more normal ear canal and middle ear reconstruction.

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2017 World journal of otorhinolaryngology - head and neck surgery

6. Clinical Aspects and Surgical Outcomes of Congenital Cholesteatoma in 93 Children: Increasing Trends of Congenital Cholesteatoma from 1997 through 2012 (PubMed)

Clinical Aspects and Surgical Outcomes of Congenital Cholesteatoma in 93 Children: Increasing Trends of Congenital Cholesteatoma from 1997 through 2012 The recent increase in the reported incidence of congenital cholesteatoma (CC) may be secondary to the widespread use of otoendoscopy as well as an increased awareness of these lesions among primary care physicians. However, little research about CC has been conducted in a large group of patients. This study aimed to analyze the clinical

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2016 Journal of Audiology & Otology

7. The benefit of trans-attic endoscopic control of ossicular prosthesis after cholesteatoma surgery. (PubMed)

The benefit of trans-attic endoscopic control of ossicular prosthesis after cholesteatoma surgery. To show the efficiency of using transmastoid atticotomy (TMA) endoscopy on the outcome of ossiculoplasty in patients with cholesteatoma. TMA is often performed as part of the surgical management of patients with middle ear cholesteatoma extending to the epitympanum. TMA can also be used as an access for endoscopic view to confirm the right alignment and stability of the ossicular prosthesis (...) because the reconstruction of the tympanic membrane will obscure the visualization of the prosthesis.A retrospective study was done at a tertiary referral institute, including 133 ears with cholesteatoma that underwent canal wall-up tympanomastoidectomy (CWU) with ossicular reconstruction using titanium prosthesis between August 2013 and August 2015. Post packing of the ear canal and position, stability, and axis of the prosthesis were checked using endoscope positioned in the attic through TMA

2019 Laryngoscope

8. Spontaneous Resolution of Cholesteatoma in a Patient on Long-Term Infliximab. (PubMed)

Spontaneous Resolution of Cholesteatoma in a Patient on Long-Term Infliximab. To describe an observed case of spontaneous regression of cholesteatoma in a patient on chronic anti-tumor necrosis factor-alpha (TNF-a) therapy and inspire further research into the role of TNF-a in cholesteatoma.Clinical assessment of disease in a single-patient case report.A 49-year-old woman suffered a severe case of Stevens-Johnson syndrome when she was 12 years old, leaving her with bilateral corneal (...) opacification and tympanic membrane perforations with extensive cholesteatoma. For her corneal opacification, a corneal prosthesis was placed, which was complicated by a foreign body reaction necessitating long-term therapy with infliximab, a monoclonal antibody against TNF-a that is therapeutic in some chronic inflammatory diseases. She was otherwise healthy and took no other medications. While on infliximab, the patient had spontaneous and complete resolution of her cholesteatoma without any surgical

2019 Rhinology and Laryngology

9. Bilateral Ear Canal Cholesteatoma with Underlying Type I First Branchial Cleft Anomalies. (PubMed)

Bilateral Ear Canal Cholesteatoma with Underlying Type I First Branchial Cleft Anomalies. To describe a case of bilateral ear canal cholesteatomas in the setting of underlying first branchial cleft cyst anomalies and to review the pathophysiology underlying the development of external auditory canal cholesteatomas from branchial cleft cyst abnormalities.We present a case study of a 61-year-old man who presented with chronic right-sided hearing loss and left-sided postauricular drainage (...) . Clinical evaluation, radiographic work-up, and pathologic analysis confirmed a diagnosis of bilateral ear canal cholesteatoma in the setting of underlying first branchial cleft cyst anomalies. The patient's clinical course, surgical treatment, and management considerations are discussed here.Ear canal cholesteatoma represents a rare clinical disease entity deserving a thorough initial assessment. Careful consideration of underlying diseases that result in chronic inflammation, such as branchial cleft

2019 Rhinology and Laryngology

10. Localisation of basic fibroblast growth factor in cholesteatoma matrix: an immunochemical study. (PubMed)

Localisation of basic fibroblast growth factor in cholesteatoma matrix: an immunochemical study. To investigate the expression of basic fibroblast growth factor in the matrix of human acquired cholesteatoma compared to the deep meatal skin. This topic does not appear to have been fully investigated before.An immunochemical study was conducted. Cholesteatoma tissues from adult patients were collected during surgery (n = 19). Control specimens were taken from the deep meatal skin (n = 8 (...) ) and compared.A highly significant difference in basic fibroblast growth factor expression was identified between cholesteatoma and skin (mean ± standard error = 58.53 ± 3.6 per cent in cholesteatoma vs 40.6 ± 3.5 per cent in skin; p = 0.005). Both basal and parabasal keratinocytes were stained positive with basic fibroblast growth factor. Additionally, there was specific staining in the basal columnar middle-ear epithelium and mast cell membrane.Basic fibroblast growth factor plays an active role

2019 Journal of Laryngology & Otology

11. The Value of Diffusion-Weighted MRI in the Long-term follow-up After Subtotal Petrosectomy for Extensive Cholesteatoma and Chronic Suppurative Otitis Media. (PubMed)

The Value of Diffusion-Weighted MRI in the Long-term follow-up After Subtotal Petrosectomy for Extensive Cholesteatoma and Chronic Suppurative Otitis Media. To report the long-term follow-up with diffusion-weighted magnetic resonance imaging (DW MRI) after subtotal petrosectomy (SP) with blind sac closure of the external auditory canal for extensive cholesteatoma and chronic suppurative otitis media.Retrospective clinical record study.Tertiary referral center.Thirty-one patients (31 ears (...) ) with extensive cholesteatoma and 17 patients (19 ears) with chronic suppurative otitis media without cholesteatoma who underwent SP between July 1995 and December 2015.All 48 patients were followed clinically and with DW MRI to rule out residual cholesteatoma.Residual cholesteatoma, indicated by a marked hyperintensity on non-echoplanar (non-EP) DW MRI.In the cholesteatoma group the mean interval between surgery and the latest DW MRI was 3.9 years. Seven patients presented with a residual cholesteatoma pearl

2019 Otology and Neurotology

12. Is transcanal tympanoplasty an appropriate surgical treatment for congenital middle ear cholesteatoma with ossicular involvement? (PubMed)

Is transcanal tympanoplasty an appropriate surgical treatment for congenital middle ear cholesteatoma with ossicular involvement? The aims of this study are to analyze the clinical characteristics of congenital middle ear cholesteatoma (CMC), to evaluate the treatment results according to the types of surgical approach, and to suggest the appropriate surgical treatment option in each stage.One hundred fifteen children (≤15 years old) with surgically confirmed CMC, who underwent surgery

2019 International Journal of Pediatric Otorhinolaryngology

13. Growth and Late Detection of Post-Operative Cholesteatoma on Long Term Follow-Up With Diffusion Weighted Magnetic Resonance Imaging (DWI MRI): A Retrospective Analysis From a Single UK Centre. (PubMed)

Growth and Late Detection of Post-Operative Cholesteatoma on Long Term Follow-Up With Diffusion Weighted Magnetic Resonance Imaging (DWI MRI): A Retrospective Analysis From a Single UK Centre. To evaluate the growth rate and late detection of residual cholesteatoma on long-term follow-up with diffusion weighted magnetic resonance imaging (DWI MRI) in clinically stable ears following definitive surgery, in order to define surveillance imaging protocols.Retrospective case review.Tertiary referral (...) center.Patients who underwent DWI MRI at our institution between February 2007 and May 2013 for postoperative cholesteatoma follow-up.Non-echo planar imaging (non-EPI) Half-Fourier Acquisition Single-shot Turbo spin Echo (HASTE) DWI MRI.Intervals between the definitive surgery and the first and subsequent DWI MRI, the maximum coronal dimension of the lesion on DWI and length of follow-up.The study evaluated 152 postoperative DWI studies performed for 88 patients. In 12 cases, DWI was initially negative

2019 Otology and Neurotology

14. Non-microscopic Middle Ear Cholesteatoma Surgery: A Case Report of a Novel Head-Up Approach. (PubMed)

Non-microscopic Middle Ear Cholesteatoma Surgery: A Case Report of a Novel Head-Up Approach. To assess the feasibility of a postauricular transcortical mastoidectomy utilizing an exoscope, which offers 3D stereoscopic visualization.Clinical capsule report.Two consecutive patients with cholesteatoma involvement in the mastoid cavity were included in the study.After transcanal endoscopic surgery, postauricular mastoidectomy utilizing a surgical 3D exoscope was performed. Then, the cholesteatoma (...) in the mastoid cavity was removed through the mastoidectomy opening with endoscopes.The postauricular transcortical mastoidectomy utilizing a 3D exoscope was not only feasible, but importantly, the exoscope took little time to switch to and resulted in a smooth workflow. There was no cholesteatoma recurrence at 9 months.During endoscope-based surgery, in patients with cholesteatoma mastoid involvement, we can continue to perform the surgical procedure in a heads-up position utilizing a surgical 3D exoscope

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2019 Otology and Neurotology

15. Pre-operative prediction of cholesteatomas from radiology: retrospective cohort study of 106 cases. (PubMed)

Pre-operative prediction of cholesteatomas from radiology: retrospective cohort study of 106 cases. Pre-operative imaging is often used to predict the extent of a cholesteatoma and anatomical variation to plan for surgery. This study aimed to measure the predictive accuracy of computed tomography findings.A retrospective cohort study was conducted of all patients in a district general hospital undergoing mastoid surgery within a consecutive 12-month period, in whom computed tomography had been (...) performed prior to operative intervention. The study measured the key findings of pre-operative computed tomography imaging and compared them to the intra-operative findings.A total of 106 patients were included. The sensitivity and specificity for predicting cholesteatoma were 79 per cent and 81 per cent respectively. The positive predictive value was 90 per cent and the negative predictive value was 65 per cent. In predicting complications of cholesteatomas, the sensitivity was 70 per cent, whereas

2019 Journal of Laryngology & Otology

16. Tympanomastoidectomy for Cholesteatoma in Children: Audiometric Results. (PubMed)

Tympanomastoidectomy for Cholesteatoma in Children: Audiometric Results. The aim of this study was to investigate the audiometric outcomes of tympanomastoidectomy in children with cholesteatoma and to evaluate factors that may affect outcomes.A retrospective cohort study was conducted. All pediatric patients diagnosed with cholesteatoma who underwent primary canal wall-up tympanomastoidectomy with or without ossicular reconstruction from 2009 to 2016 at a tertiary university-affiliated (...) to the preoperative value (28.1 ± 14.7 dB) at both the first (19.1 ± 11.9 dB, P = .006) and last (22.4 ± 15.1 dB, P = .011) audiometry examinations.Hearing outcomes after pediatric cholesteatoma surgery are diverse and related to several factors. The authors found that ossicular reconstruction improves audiometric outcomes, and the changes remain stable over time.IIB.

2019 Rhinology and Laryngology

17. Negative Predictive Value of Non-Echo-Planar Diffusion Weighted MR Imaging for the Detection of Residual Cholesteatoma Done at 9 Months After Primary Surgery Is not High Enough to Omit Second Look Surgery. (PubMed)

Negative Predictive Value of Non-Echo-Planar Diffusion Weighted MR Imaging for the Detection of Residual Cholesteatoma Done at 9 Months After Primary Surgery Is not High Enough to Omit Second Look Surgery. To evaluate non echo-planar diffusion weighted magnetic resonance imaging (non-EP DW MRI) at 9 months after primary surgery to rule out residual cholesteatoma in patients scheduled before second-look-surgical exploration.Prospective observational study.Secondary teaching hospital.Patients who (...) were scheduled for second-look-surgery after primary canal wall up repair of cholesteatoma underwent 1.5 T MRI including non-EP DWI and high-resolution coronal T1 and T2-FS SE sequences.Imaging studies were evaluated for the presence of cholesteatoma by three independent observers. Intraoperative observations were regarded the standard of reference. Ear, nose, throat (ENT) surgeons were blinded for imaging findings. The primary outcome was the negative predictive value (NPV) of MR imaging

2019 Otology and Neurotology

18. Value of DW-MRI in the preoperative evaluation of congenital cholesteatoma. (PubMed)

Value of DW-MRI in the preoperative evaluation of congenital cholesteatoma. This study evaluated the clinical value of diffusion-weighted magnetic resonance imaging (DW-MRI) in the diagnosis and staging of congenital cholesteatoma (CC).We retrospectively reviewed 24 patients with CC. All the patients underwent computed tomography (CT) and DW-MRI preoperatively; thereafter, surgery was performed. DW-MRI examination was performed with a 3 T MRI system using three-dimensional reversed fast imaging (...) with steady-state precession and diffusion-weighted magnetic resonance sequence. The preoperative and operative CT and DW-MRI findings were compared.Using DW-MRI, cholesteatoma was successfully detected in 17 (71%) of the 24 patients with CC. Among the seven patients with false-negative results, the cholesteatoma mass diameter was <5 mm in six patients and ≥5 mm in one patient. One of these patients had open type congenital cholesteatoma (OTCC). The detection rates for closed type cholesteatoma and OTCC

2019 International Journal of Pediatric Otorhinolaryngology

19. Congenital cholesteatoma: Different clinical presentation in two cases (PubMed)

Congenital cholesteatoma: Different clinical presentation in two cases Congenital cholesteatoma (CC) of the middle ear is a rare entity that may be undiagnosed for years. The lesion can grow undetected until it produces symptoms such as reduced hearing or otalgia.Case report.We report two cases of young ladies with CC who presented with different otological symptoms. The first case complained of recurrent unilateral ear pain while the second case presented with unilateral reduced hearing

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2016 Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia

20. Giant Petrous Bone Cholesteatoma: Combined Microscopic Surgery and an Adjuvant Endoscopic Approach (PubMed)

Giant Petrous Bone Cholesteatoma: Combined Microscopic Surgery and an Adjuvant Endoscopic Approach Petrous bone cholesteatomas (PBCs) are epidermoid cysts, which have developed in the petrous portion of the temporal bone and may be congenital or acquired. Cholesteatomas arising in this region have a tendency to invade bone and functional structures and the middle and posterior fossae reaching an extensive size. Traditionally, surgery of a giant PBC contemplates lateral transtemporal or middle (...) fossa microscopic surgery; however, in recent years, endoscopic surgical techniques (primary or complementary endoscopic approach) are starting to receive a greater consensus for middle ear and mastoid surgeries. We report the rare case of an 83-year-old Caucasian male affected by a giant cholesteatoma that eroded the labyrinth and the posterior fossa dura and extended to the infralabyrinthine region, going beyond the theca and reaching the first cervical vertebra. The giant cholesteatoma

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2016 Journal of neurological surgery reports

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