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Cholesteatoma

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41. Clinical and cost utility of an intraoperative endoscopic second look in cholesteatoma surgery. (PubMed)

Clinical and cost utility of an intraoperative endoscopic second look in cholesteatoma surgery. This study aimed to determine the clinical and cost-effectiveness of endoscopes during cholesteatoma surgery. More specifically, this study hypothesized that endoscope use would reduce cholesteatoma recurrence rates and cost.Case series involving the prospective enrollment of 110 consecutive cholesteatoma patients over a 2-year period.Patients underwent cholesteatoma surgery with microscopy. During (...) dissection, the location of the cholesteatoma was assessed. At the end of dissection and before reconstruction, the same subunits were visualized with straight and angled endoscopes for residual cholesteatoma. Hearing was analyzed before surgery and at the last possible examination. Costs were analyzed using Medicare reimbursement rates from the Centers for Medicare and Medicaid Services.Intraoperative endoscopic surveillance was able to detect residual cholesteatoma in 18 patients. With a 0° endoscope

2018 Laryngoscope

42. The Bony Obliteration Tympanoplasty in Pediatric Cholesteatoma: Long-term Hearing Results. (PubMed)

The Bony Obliteration Tympanoplasty in Pediatric Cholesteatoma: Long-term Hearing Results. To present the hearing results of a 5-year longitudinal study in a pediatric population undergoing surgery for extensive cholesteatoma using a canal wall up (CWU) approach with bony obliteration of the mastoid and epitympanic space, with a standard residual rate of 5.8%, a recurrence rate of 2.9%, and all ears waterproof, free of otorrhea and all external ear canals patent and self-cleaning.Retrospective (...) consecutive study.Thirty-three children (≤18 yr) undergoing surgery for cholesteatoma (34 ears) between 1997 and 2009.Therapeutic.Tertiary referral center.Hearing and gain in hearing at 1- and 5-year postsurgery: (1) pure-tone average (PTA), (2) pure-tone average high frequency, (3) pure-tone average including 3 kHz, (4) bone conduction at corresponding frequency averages, (5) gain at corresponding air conduction and bone conduction (gain at corresponding air conduction) frequency averages. (6

2018 Otology and Neurotology

43. Bilateral Congenital Cholesteatoma. (PubMed)

Bilateral Congenital Cholesteatoma. To report the first large case series of extremely rare bilateral congenital cholesteatoma (CC).A retrospective cohort study.University hospital otology referral clinic.Six hundred four children with surgically confirmed CC.The bilateral CCs were compared with the unilateral CCs.The incidence of bilateral CC was 3.6% (22/615) per case or 1.8% (11/604) per child. Bilateral CC did not differ from unilateral CC regarding its demographics, and invasiveness (...) by the proportion of advanced CC as 31.8% (7/22) versus 28.2% (167/594). But the invasiveness or location randomly differed between the ears, that advanced CC per child was higher as 45.4% (5/11). Bilateral exploration was attempted with a concern for hearing loss, which featured a combination of laser myringotomy to treat early CC and endaural laser-assisted single-stage inside-out cholesteatoma surgery to treat advanced CC. Bilateral exploration was difficult in three children with initially negative

2018 Otology and Neurotology

44. Application of Regenerative Treatment for Tympanic Membrane Perforation With Cholesteatoma, Tumor, or Severe Calcification. (PubMed)

Application of Regenerative Treatment for Tympanic Membrane Perforation With Cholesteatoma, Tumor, or Severe Calcification. To apply regenerative treatment for tympanic membrane (TM) perforation to patients with severe calcification of the TM, cholesteatomas, or tumors localized to the tympanic cavity.Controlled clinical pilot study.General hospitals.Forty-five patients (age: 8-85; M = 19, F = 26) were selected from patients with or without TM perforation for the regenerative treatment. Twenty (...) -five patients had cholesteatomas, 3 had tumors, and 17 had severe TM calcification. Patients were classified into three groups based on TM perforation size: less than 1/3 of the TM as Grade I (n = 5), 1/3 to 2/3 as Grade II (n = 19), and over 2/3 as Grade III (n = 21). Twenty patients who underwent standard tympanoplasty type I were selected as historical controls.Materials for the TM repair included gelatin sponge with basic fibroblast growth factor and fibrin glue. After lesions were removed

2018 Otology and Neurotology

45. Radiological differences between HIV-positive and HIV-negative children with cholesteatoma. (PubMed)

Radiological differences between HIV-positive and HIV-negative children with cholesteatoma. HIV-positive children are possibly more prone to developing cholesteatoma. Chronic inflammation of the middle ear cleft may be more common in patients with HIV and this may predispose HIV-positive children to developing cholesteatoma. There are no studies that describe the radiological morphology of the middle ear cleft in HIV-positive compared to HIV-negative children with cholesteatoma.Compare (...) the radiological differences of the middle ear cleft in HIV-positive and HIV-negative children with cholesteatoma.A retrospective, cross-sectional, observational analytical review of patients with cholesteatoma at our institute over a 6 year period.Forty patients were included in the study, 11 of whom had bilateral cholesteatoma and therefore 51 ears were eligible for our evaluation. HIV-positive patients had smaller (p=0.02) mastoid air cell systems (MACS). Forty percent of HIV-positive patients had sclerotic

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2018 International Journal of Pediatric Otorhinolaryngology

46. External auditory canal cholesteatoma and benign necrotising otitis externa: clinical study of 95 cases in the Capital Region of Denmark. (PubMed)

External auditory canal cholesteatoma and benign necrotising otitis externa: clinical study of 95 cases in the Capital Region of Denmark. To identify epidemiological and pathophysiological factors, and treatment strategies, in external auditory canal cholesteatoma and benign necrotising otitis externa.A retrospective case study was conducted of patients suffering from external auditory canal cholesteatoma and benign necrotising otitis externa admitted to tertiary hospitals, in the Capital (...) Region of Denmark, over a five-year period.Eighty-three patients (95 ears) with external auditory canal cholesteatoma or benign necrotising otitis externa were identified. A minimum incidence rate of 0.97 per 100 000 inhabitants per year was demonstrated. Sixty-eight per cent of cases had a history of smoking. Most lesions (74 per cent) were localised in the floor of the ear canal. Treatment time was 3.2 months for patients who had surgery and 6.0 months for those who received conservative

2018 Journal of Laryngology & Otology

47. Single-Stage Mastoid Obliteration in Cholesteatoma Surgery and Recurrent and Residual Disease Rates: A Systematic Review. (PubMed)

Single-Stage Mastoid Obliteration in Cholesteatoma Surgery and Recurrent and Residual Disease Rates: A Systematic Review. The ideal surgical treatment of cholesteatoma has been subject to discussion for years because both traditional surgical techniques (canal wall down [CWD] and canal wall up [CWU] tympanoplasty) have their own advantages and disadvantages. A more recently propagated surgical approach, to combine the CWD or CWU tympanoplasty technique with obliteration of the mastoid (...) and epitympanum, is showing promising results.To systematically review the literature on recurrent and residual cholesteatoma rates after single-stage CWU and CWD tympanoplasty with mastoid obliteration.A systematic search of literature was performed to identify relevant publications in multiple electronic databases. The initial search was conducted in December 2016 and was updated in July 2017. Each study was reviewed by 2 independent reviewers on predetermined eligibility criteria. The methodological

2018 JAMA otolaryngology-- head & neck surgery

48. Bilateral congenital cholesteatoma: A case report and review of the literature. (PubMed)

Bilateral congenital cholesteatoma: A case report and review of the literature. Congenital cholesteatoma (CC) occurs less commonly than acquired cholesteatoma (AC), and bilateral CC (BCC) is even more rare with only 38 such cases having been reported in the past 42 years. Because of the rarity of this condition, providers confronted with cases of BCC may find it difficult to treat while balancing complete removal of disease, optimal hearing outcomes, and minimized surgical burden (...) in the pediatric patient. This review alerts physicians that BCC occurs, highlights past presentations and management strategies, describes the considerations in treatment and offers an algorithm helpful in the management of BCC.Review of a single case with extensive review of published reports from 1975 to 2017 pertaining to management of BCC.A five-year-old boy presented with bilateral congenital cholesteatoma. Tympanomastoidectomy was performed to remove cholesteatoma in the left ear then in the right ear

2018 International Journal of Pediatric Otorhinolaryngology

49. Cochlear Implantation in Chronic Otitis Media With Cholesteatoma and Open Cavities: Long-term Surgical Outcomes. (PubMed)

Cochlear Implantation in Chronic Otitis Media With Cholesteatoma and Open Cavities: Long-term Surgical Outcomes. To evaluate the long-term surgical outcomes of cochlear implantation (CI) in chronic otitis media (COM) with cholesteatoma and open cavities using subtotal petrosectomy (STP). To review device explantation (DE) patients and reimplantation considerations.Retrospective review.Otology and skull base center.Charts of 35 patients (36 ears) with COM with cholesteatoma, including open (...) cavities, who underwent CI were reviewed for surgical outcomes and DE. Patient demographics, pathologies, previous surgeries, staging of implantation, salient intraoperative findings at the time of implantation and follow-up were evaluated. Details of patients with DE were evaluated for cause, operative findings, and reimplantation considerations.Mean age of patients was 65.94 years. Nineteen open cavities, 11 primary cholesteatomas, 3 petrous bone cholesteatomas, and 3 atelectatic middle ears

2018 Otology and Neurotology

50. Challenges and outcomes of cholesteatoma management in children with Down syndrome. (PubMed)

Challenges and outcomes of cholesteatoma management in children with Down syndrome. The high incidence of chronic otitis media with effusion and Eustachian tube dysfunction in children with Down syndrome (DS) may predispose them to cholesteatoma formation. Establishing the diagnosis, choosing the appropriate operative intervention, and post-operative care can be challenging.To describe management strategies for cholesteatoma diagnosis, surgical treatment, and post-operative management (...) in children with Down syndrome.Retrospective case series of 14 patients (17 total ears) with Down syndrome diagnosed with cholesteatoma over a 9-year period.A total of 14 patients with cholesteatoma (3 with bilateral disease) were analyzed. Thirteen ears (76.5%) had ≥2 tympanostomy tubes insertions prior to cholesteatoma diagnosis, and otorrhea and hearing loss were the most common presenting symptoms. Common pre-operative CT scan findings included mastoid sclerosis and ossicular erosion. The average age

2018 International Journal of Pediatric Otorhinolaryngology

51. No evidence of cholesteatoma in untreated otitis media with effusion in children with primary ciliary dyskinesia. (PubMed)

No evidence of cholesteatoma in untreated otitis media with effusion in children with primary ciliary dyskinesia. Primary Ciliary Dyskinesia (PCD) describes a group of inherited disorders that result in abnormal ciliary motion leading to mucous stasis. Clinical features include almost universally otitis media with effusion (OME), particularly in infants. PCD patients provide us with a cohort of patients with OME that is not treated with ventilatory tube (VT) insertion as these have been shown (...) to result in frequent complications including chronic otorrhoea, early extrusion and persistent perforation without significant improvement to hearing in the long term. This cohort was used to investigate whether children with PCD and OME not treated with VT were predisposed to cholesteatoma formation in the setting of a paediatric quaternary referral centre.A retrospective chart review was performed of all the children attending a multi-disciplinary PCD clinic at a national quaternary referral centre

2018 International Journal of Pediatric Otorhinolaryngology

52. One-Stage Complete Resection of Cholesteatoma With Labyrinthine Fistula: Hearing Changes and Clinical Outcomes. (PubMed)

One-Stage Complete Resection of Cholesteatoma With Labyrinthine Fistula: Hearing Changes and Clinical Outcomes. To evaluate long-term hearing changes and surgical outcomes for middle ear cholesteatoma with labyrinthine fistula following complete surgical removal of the cholesteatoma matrix.Consecutive samples of 43 patients who underwent 1-stage complete resection of the cholesteatoma matrix overlying a labyrinthine fistula were obtained. Immediate and long-term hearing changes were analyzed (...) of them had had preoperative air conduction threshold above 90 dB. Their fistulas were significantly larger than those of patients without hearing loss ( P = .027).Although caution is required for total removal of a large fistula, owing to increased risk of postoperative hearing deterioration, 1-stage complete resection of cholesteatoma matrix on labyrinthine fistula could be effective in disease control and long-term hearing preservation.

2018 Rhinology and Laryngology

53. ADC Benchmark Range for Correct Diagnosis of Primary and Recurrent Middle Ear Cholesteatoma (PubMed)

ADC Benchmark Range for Correct Diagnosis of Primary and Recurrent Middle Ear Cholesteatoma Magnetic resonance imaging (MRI) and in particular diffusion-weighted imaging (DWI) have been broadly proven to be the reference imaging method to discriminate between cholesteatoma and noncholesteatomatous middle ear lesions, especially when high tissue specificity is required. The aim of this study is to define a range of apparent diffusion coefficient (ADC) values within which the diagnosis (...) of cholesteatoma is almost certain.The study was retrospectively conducted on a cohort of 124 patients. All patients underwent first- or second-look surgery because primary or secondary acquired cholesteatoma was clinically suspected; they all had preoperative MRI examination 15 days before surgery, including DWI from which the ADC maps were calculated.Average ADC value for cholesteatomas was 859,4 × 10-6 mm2/s (range 1545 × 10-6 mm2/s; IQR = 362 × 10-6 mm2/s; σ = 276,3 × 10-6 mm2/s), while

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2018 BioMed research international

54. Stem cells in middle ear cholesteatoma contribute to its pathogenesis (PubMed)

Stem cells in middle ear cholesteatoma contribute to its pathogenesis Cholesteatoma is a potentially life-threatening middle ear lesion due to the formation of an inflamed ectopic mass of keratinizing squamous epithelium. Surgical removal remains the only treatment option, emphasizing the need to gain a better understanding of this severe disease. We show for the first time that stem cells residing in cholesteatoma tissue contribute to disease progression. Cells expressing the "stemness (...) " markers Nestin and S100B were detected in middle ear cholesteatoma and auditory canal skin. Isolated Nestin + /S100B + -cells showed the capability for self-renewal, neurosphere formation and differentiation into mesodermal and ectodermal cell types. Compared to auditory canal skin stem cells middle ear cholesteatoma-derived stem cells displayed an enhanced susceptibility to inflammatory stimuli, and this suggested a possible contribution to the inflammatory environment in cholesteatoma tissue

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2018 Scientific reports

55. Comparison of changes in mitochondrial bioenergetics between keratinocytes in human external auditory canal skin and cholesteatomas from normoxia to hypoxia (PubMed)

Comparison of changes in mitochondrial bioenergetics between keratinocytes in human external auditory canal skin and cholesteatomas from normoxia to hypoxia Cholesteatoma has attracted many studies seeking to uncover its nature and the pathogenesis of related diseases. However, no researchers have explored the mitochondrial bioenergetics of cholesteatoma. The aim of this study was to investigate the energy demand and differential mitochondrial respiration profiles between keratinocytes (...) in external auditory canal (EAC) skin and cholesteatoma samples cultured in normoxic (20% O2) and hypoxic (5% O2) conditions. Enhanced cellular proliferation of both types of keratinocytes was found in hypoxia compared to normoxia. In 20% O2 conditions, cholesteatoma keratinocytes exhibited less mitochondrial mass, lower ATP levels, and significantly lower basal oxygen consumption rate (OCR) and reserve capacity compared to normal skin keratinocytes. In contrast, in hypoxic conditions, cholesteatoma

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2018 Scientific reports

56. A giant cholesteatoma of the mastoid extending into the foramen magnum: A case report and review of literature (PubMed)

A giant cholesteatoma of the mastoid extending into the foramen magnum: A case report and review of literature Cholesteatomas are very rare benign, progressive lesions that have embryologic derivation and usually result in progressive exfoliation and confinement of squamous epithelium behind an intact or preciously infected tympanic membrane. To the best of our understanding no reports demonstrates the extension of cholesteatoma from the temporal bone into the foramen magnum. We therefore (...) present a case of cholesteatoma extending down into the foramen magnum. We report a case of 67- year-old man with a giant cholesteatoma extending into the foramen magnum without substantial destruction of the mastoid and petrous temporal bones. The patient's major symptoms were recurrent tinnitus in the left ear and dizziness with unilateral conductive hearing loss. A working diagnosis of cholesteatomas was made combining the symptoms and magnetic resonance imaging findings. He was then successfully

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2018 Neurology international

57. Treatment of cholesteatoma with intact ossicular chain: anatomic and functional results (PubMed)

Treatment of cholesteatoma with intact ossicular chain: anatomic and functional results In case of cholesteatoma with intact ossicular chain, the primary aims of surgery are complete removal of the cholesteatoma matrix and reconstruction of a dry and safe middle ear; if possible, ossicular chain continuity and therefore the preoperative hearing must be preserved. The aim of this retrospective study is to present the experience of the U.O.C. Otorinolaringoiatria Universitaria of University (...) of Bari "Aldo Moro" in treatment of intact ossicular chain cholesteatoma with Bondy modified radical mastoidectomy (BMRM) and canal wall up tympanoplasty (CWUT). The study group was composed of 65 subjects affected by cholesteatoma with intact ossicular chain. Mean age was 40.7 years (range 6-79), with 42 males and 23 females. 30 patients were treated by a BMRM and 35 by CWUT, in 22 cases without mastoidectomy and in 13 cases with mastoidectomy. Mean follow-up was 24.25 months. In the BMRM group

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2018 Acta Otorhinolaryngologica Italica

58. Bilateral tympanokeratomas (cholesteatomas) with bilateral otitis media, unilateral otitis interna and acoustic neuritis in a dog (PubMed)

Bilateral tympanokeratomas (cholesteatomas) with bilateral otitis media, unilateral otitis interna and acoustic neuritis in a dog An aural cholesteatoma, more appropriately named tympanokeratoma, is an epidermoid cyst of the middle ear described in several species, including dogs, humans and Mongolian gerbils. The cyst lining consists of stratified, keratinizing squamous epithelium with central accumulation of a keratin debris. This case report describes vestibular ganglioneuritis

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2018 Acta veterinaria Scandinavica

59. Microarray Analysis of Differentially-expressed MicroRNAs in Acquired Middle Ear Cholesteatoma (PubMed)

Microarray Analysis of Differentially-expressed MicroRNAs in Acquired Middle Ear Cholesteatoma Objectives: To analyze the miRNAs expression profiling between acquired middle ear cholesteatoma and normal skin, and to identify several novel miRNAs which may be involved in the etiopathogenesis of middle ear cholesteatoma. Methods: MiRNA microarray technology was adopted to analyze the miRNA expression profiling between acquired middle ear cholesteatoma and normal skin. qRT-PCR was used to validate (...) selected differentially expressed miRNAs. Results: The miRNA microarray technology showed totally 44 upregulated (miRNA-21-3p, miRNA-584-5p, miRNA-16-1-3p, etc) and 175 downregulated (miRNA-10a-5p, miRNA-152-5p, miRNA-203b-5p, etc) miRNAs in cholesteatoma tissues with 2-fold change compared with normal skin. The qRT-PCR validation was in accordance with the microarray results partly: miRNA-21-3p and miRNA-16-1-3p expressed significantly higher while miRNA-10a-5p exhibited an obviously decreased

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2018 International journal of medical sciences

60. Canal wall up surgery with mastoid and epitympanic obliteration in acquired cholesteatoma. (PubMed)

Canal wall up surgery with mastoid and epitympanic obliteration in acquired cholesteatoma. The objective of this study was to evaluate surgical outcome and residual and recurrence rates of canal wall up (CWU) surgery with obliteration of the mastoid and epitympanum.Retrospective cohort study in a tertiary referral center.Patients with (sequelae of) acquired cholesteatoma treated with primary or revision CWU surgery with obliteration of the epitympanum and mastoid were identified retrospectively (...) this difference was not statistically significant, a trend was observed (P = .066).Obliteration of the epitympanum and mastoid is a reliable and safe technique following CWU surgery for cholesteatoma, resulting in low residual and recurrence rates.4 Laryngoscope, 129:981-985, 2019.© 2018 The American Laryngological, Rhinological and Otological Society, Inc.

2018 Laryngoscope

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