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Cholesteatoma

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81. Risk Factors of Recurrence in Pediatric Congenital Cholesteatoma. (PubMed)

Risk Factors of Recurrence in Pediatric Congenital Cholesteatoma. To examine the risk factors of recurrence in pediatric congenital cholesteatoma.Retrospective chart review.University hospital.Sixty-seven patients having tympanic type of congenital cholesteatoma under 15-years old at surgery.Canal wall-up tympanomastoidectomy (n = 30) or transcanal atticotomy/tympanoplasty (n = 37) was performed depending on cholesteatoma extension, 16 of which were followed by second-look surgery. Preoperative (...) computed tomography (CT) before second-look surgery or follow-up CT was performed to detect residual recurrence 1 year after the surgery. Cholesteatoma found at the second surgery was also included in the recurrence. All patients had no recurrent cholesteatoma at the last follow-up (median, 61 mo after surgery).Possible predictive factors were compared between the groups.Residual cholesteatoma and retraction cholesteatoma occurred in 21 and 6%, respectively. There was no significant difference in age

2017 Otology and Neurotology

82. Evidence against the mucosal traction theory in cholesteatoma. (PubMed)

Evidence against the mucosal traction theory in cholesteatoma. To investigate the distribution of ciliated epithelium in the human middle ear and its potential role in the formation of cholesteatoma.Comparative human temporal bone study.We selected temporal bones from 14 donors with a diagnosis of cholesteatoma, 15 with chronic otitis media without retraction pockets, 14 with chronic otitis media with retraction pockets, 14 with cystic fibrosis (CF), and 16 controls. We mapped the distribution (...) of the ciliated cells in the mucosal lining of the middle ear and tympanic membrane using three-dimensional reconstruction analysis, and counted the number of ciliated cells in the middle ear mucosa.Ciliated cells are extremely sparse in the epithelial lining of the lateral surface of the ossicles in the epitympanum and the medial surface of the tympanic membrane. Furthermore, there is a significant decrease in the number of ciliated cells in these areas in temporal bones with cholesteatoma, chronic otitis

2017 Laryngoscope

83. Clinical Characteristics and Treatment Outcomes for Patients With External Auditory Canal Cholesteatoma. (PubMed)

Clinical Characteristics and Treatment Outcomes for Patients With External Auditory Canal Cholesteatoma. We aimed to evaluate the clinical features and treatment outcomes for patients with idiopathic and secondary external auditory canal cholesteatoma (EACC), and to validate the treatment strategy from the perspective of hearing as well as etiology and staging.Retrospective case series.Tertiary referral center and affiliated hospitals.Fifty-eight patients with idiopathic EACC and 14 patients

2017 Otology and Neurotology

84. Postoperative efficacy analysis of patients with facial nerve palsy associated with cholesteatoma otitis media: Our experience with 32 patients. (PubMed)

Postoperative efficacy analysis of patients with facial nerve palsy associated with cholesteatoma otitis media: Our experience with 32 patients. 29168315 2019 02 04 2019 02 15 1749-4486 43 2 2018 04 Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery Clin Otolaryngol Postoperative efficacy analysis of patients with facial nerve palsy associated with cholesteatoma otitis media: Our experience with 32 (...) , Shanghai, China. Shi H-B HB Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China. Chen Z-N ZN 0000-0001-7774-441X Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China. Yin S-K SK Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China. eng Journal Article 2017 12 20 England Clin Otolaryngol 101247023 1749-4478 IM Adult Cholesteatoma

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2017 Clinical Otolaryngology

85. Complete Malleus Removal for Cholesteatoma: A Multivariate Analysis of Ossiculoplasty Success and Residual Disease. (PubMed)

Complete Malleus Removal for Cholesteatoma: A Multivariate Analysis of Ossiculoplasty Success and Residual Disease. Determine the effect of complete malleus removal during canal wall up tympanomastoidectomy for cholesteatoma on ossiculoplasty success and rate of residual cholesteatoma.We reviewed the operative, audiogram, and clinical reports of patients who underwent canal wall up tympanomastoidectomy for cholesteatoma between 2009 and 2016 at a tertiary academic medical center with at least 8 (...) months of follow-up after surgery. To control for extent of disease, we independently catalogued the subsites of the middle ear and mastoid that cholesteatoma involved from each operation. We performed multivariate logistic regression to determine the independent effect of complete removal of the malleus on the rate of residual disease and success of ossiculoplasty.One hundred eighty surgeries were included in the analysis. For ossiculoplasty success, the adjusted odds ratio of complete malleus

2017 Rhinology and Laryngology

86. Bilateral congenital cholesteatoma: Surgical treatment and considerations. (PubMed)

Bilateral congenital cholesteatoma: Surgical treatment and considerations. To describe a multicenter study regarding surgical management of bilateral congenital cholesteatoma (BCC) and underline the importance of endoscopes in the management of this condition. In BCC, hearing preservation is more crucial than in unilateral cases. The endoscopic approach allows complete removal of cholesteatoma via a minimally invasive technique offering low residual disease rates while preserving the normal (...) physiology of the middle ear and possibly the ossicular chain.Retrospective chart and surgical video review of patients with BCC who underwent surgery at Otolaryngology Department of Modena and Verona University Hospitals and the Hospital for Sick Children, Toronto.From 2002 to November 2016, six patients were identified with bilateral congenital cholesteatoma and included in this study. Pre-operative assessments, surgical treatments and outcomes were collected and described.The median age

2017 International Journal of Pediatric Otorhinolaryngology

87. Increased risk of cholesteatoma among patients with allergic rhinitis: A nationwide investigation. (PubMed)

Increased risk of cholesteatoma among patients with allergic rhinitis: A nationwide investigation. No large population-based studies have reported on the risk of cholesteatoma developing after allergic rhinitis (AR). This study used a nationwide population-based claims database to investigate the hypothesis that AR may increase the risk of cholesteatoma.Retrospective cohort study.Data from Taiwan's Longitudinal Health Insurance Database were analyzed to compile the following: 1) 15,953 patients (...) newly diagnosed with AR between 1997 and 2000, and 2) a comparison cohort of 63,812 matched non-AR enrollees (with a ratio of 1 to 4). Each patient was followed for 10 years to identify cases in which cholesteatoma subsequently developed. The Kaplan-Meier method was used to determine the cholesteatoma-free survival rate, and the log-rank test was used to compare survival curves. Cox proportional hazard regressions were performed to compute adjusted hazard ratios (HRs).Among the 79,765 patients

2017 Laryngoscope

88. Cholesteatoma as a complication of Langerhans Cell Histiocytosis of the temporal bone: A nationwide cross-sectional analysis. (PubMed)

Cholesteatoma as a complication of Langerhans Cell Histiocytosis of the temporal bone: A nationwide cross-sectional analysis. To determine if patients with Langerhans Cell Histiocytosis (LCH) of the temporal bone have a higher risk of developing cholesteatoma.Review of literature and cross-sectional weighted analysis of patients under 19 with a diagnosis of LCH from the National Inpatient Sample (NIS) and Kids' Inpatient Database (KID) from 2000 to 2013. ICD-9 codes and demographics were (...) analyzed; pairwise comparisons and multivariate analyses were performed.Only seven cases of cholesteatoma after the treatment for LCH of the temporal bone have been documented in the literature. No significant association between cholesteatoma and LCH was seen (OR 0.747 [0.149-3.751]). Patients with LCH did have a higher incidence of chronic otitis media, chronic otitis externa, chronic sinusitis, hearing loss, and otitis media with effusion.Our results show that patients with Langerhans Cell

2017 International Journal of Pediatric Otorhinolaryngology

89. The Prevention of Recurrent Cholesteatoma in CWU Surgery: The Use of Titanium Sheeting. (PubMed)

The Prevention of Recurrent Cholesteatoma in CWU Surgery: The Use of Titanium Sheeting. Assessment of the outcomes of a technique of prevention of recurrent cholesteatoma in canal wall up (CWU) mastoidectomy, using titanium sheeting to repair the external auditory canal wall.Sixty four cholesteatoma cases were managed during a period from 2007 to 2015. The cases were unselected; the surgery was performed by the senior author. Cholesteatoma Patterns Were: Forty two attic, nine pars tensa, seven

2017 Otology and Neurotology

90. Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis. (PubMed)

Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis. Chronic rhinosinusitis (CRS) can cause an obstruction of the tubal orifice and thereby compromise ventilation of the middle ear. The resulting negative pressure in the middle ear may, in turn, lead to the formation of an eardrum retraction pocket and subsequent acquired cholesteatoma. This study hypothesizes that CRS may increase the risk of cholesteatoma.To evaluate the risk of cholesteatoma in patients with CRS.This (...) study used a nationwide, population-based claims database to test the hypothesis that CRS may increase the risk of cholesteatoma. The Longitudinal Health Insurance Database of Taiwan was used to compile data from (1) 12 670 patients with newly diagnosed CRS between January 1, 1997, and December 31, 2002, and (2) a comparison cohort of 63 350 matched individuals without CRS, resulting in a CRS vs control ratio of 1:5. Data analysis was performed from June 1 to October 27, 2015. Each patient

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2017 JAMA otolaryngology-- head & neck surgery

91. The Genetics of Cholesteatoma. A Systematic Review using Narrative Synthesis. (PubMed)

The Genetics of Cholesteatoma. A Systematic Review using Narrative Synthesis. A cholesteatoma is a mass of keratinising epithelium in the middle ear. It is a rare disorder that is associated with significant morbidity, and its causative risk factors are poorly understood; on a global scale, up to a million people are affected by this each year. We have conducted a systematic literature review to identify reports about the heritability of cholesteatoma or any constitutional genetic factors (...) that may be associated with its aetiology.A systematic search of MEDLINE (EBSCO) and two databases of curated genetic research (OMIM and Phenopedia) was conducted.The participants and populations of interest for this review were people treated for cholesteatoma and their family members. The studies of interest reported evidence of heritability for the trait, or any association with congenital syndromes and particular genetic variants.The searches identified 449 unique studies, of which 35 were included

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2017 Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

92. Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma. (PubMed)

Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma. To describe outcomes for endoscopic ear surgery (EES) for pediatric cholesteatoma at a tertiary pediatric hospital.Retrospective case series of 65 pediatric cholesteatoma cases in 38 ears. Subgrouping based on cholesteatoma type and EES type. Surgical findings, outcomes, and demographic data were evaluated.Endoscopes were used in 65 pediatric cholesteatoma cases in 38 primary ears (34 patients), followed (...) for an average of 2.6 years (9 months to 4.6 years). The endoscope was used as the primary visualization tool in 31 (81.6%) ears (EES 2 or 3), and as an adjunct to the microscope in seven ears (EES 1). Twenty-two (57.9%) ears and 35 (53.4%) cases were transcanal endoscopic ear surgery (EES 3 or TEES). Overall, there was recurrence in five (13.2%) ears and residual in four (10.5%) ears. Cholesteatoma was acquired in 27 ears, with average age 10.9 years; and congenital in 11 ears, with average age 3.8 years

2017 Laryngoscope

93. A Meta-Analysis on the Diagnostic Performance of Non-Echoplanar Diffusion-Weighted Imaging in Detecting Middle Ear Cholesteatoma: 10 Years on. (PubMed)

A Meta-Analysis on the Diagnostic Performance of Non-Echoplanar Diffusion-Weighted Imaging in Detecting Middle Ear Cholesteatoma: 10 Years on. To describe via a meta-analysis of the published literature, the performance of non-echo-planar diffusion weighted imaging (DWI) in detecting middle ear cholesteatoma.A systematic review of the published literature was performed to identify original studies evaluating the diagnostic performance of non-echo-planar DWI in detecting middle ear cholesteatoma (...) . Only studies with surgical correlation were included. A bi-variate meta-analysis and hierarchical summary receiver operating characteristic model was performed.A total of 26 studies (1,152 patient episodes) were included. Pooled sensitivity and specificity of 0.91 (95% CI: 0.87-0.95) and 0.92 (95% CI: 0.86-0.96), respectively were obtained. Separate subgroup analysis performed for primary cholesteatoma, postoperative cholesteatoma, pediatric cases, and adult cases all showed high sensitivities

2017 Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

94. Transcanal Endoscopic Ear Surgery for Middle Ear Cholesteatoma. (PubMed)

Transcanal Endoscopic Ear Surgery for Middle Ear Cholesteatoma. To evaluate the clinical parameters, outcomes, and complications of transcanal endoscopic ear surgeries for middle ear cholesteatoma.Retrospective study.Tertiary university-affiliated medical center.Adult patients (age >18) who underwent transcanal endoscopic ear surgeries for cholesteatoma, between March 2009 and March 2015.Transcanal endoscopic surgery was indicated when the cholesteatoma did not extend posterior to the anterior (...) limb of the lateral semicircular canal. Rigid endoscopes 4 and 2.7 mm in diameter, 0, 30, 45, and 70 degrees were used with angled picks, suction, and forceps.Preoperative assessment included high-resolution computed tomography of the temporal bones and/or non echo-planar diffusion-weighted magnetic resonance imaging and pure-tone audiometry.Residual or recurrent disease was diagnosed by clinical examination and/or magnetic resonance imaging findings consistent with cholesteatoma. Intra

2017 Otology and Neurotology

95. Endoscopic Ear Surgery for External Auditory Canal Cholesteatoma. (PubMed)

Endoscopic Ear Surgery for External Auditory Canal Cholesteatoma. Treatment of external auditory canal cholesteatoma (EACC) has been a question of debate. To our knowledge and according to a systematic review of endoscopic ear surgery (EES) in 2015, this study describes for the first time the technique and outcome by solely transcanal EES for EACC.Retrospective case series, level of evidence IV.Between October 2014 and December 2016, nine patients with unilateral EACC have been treated by EES

2017 Otology and Neurotology

96. The Role of Rho/Rho-Kinase Pathway in the Pathogenesis of Cholesteatoma. (PubMed)

The Role of Rho/Rho-Kinase Pathway in the Pathogenesis of Cholesteatoma. To assess the role of Rho/Rho-kinase pathway in the pathogenesis of cholesteatoma.Thirty-eight patients with cholesteatoma, who had gone mastoidectomies were enrolled in this prospective study. Cholesteatomas matrix (CM) and a piece of the external ear canal skin (EECS as control) were taken and transferred to the liquid nitrogen and kept at -86 °C for Rho A and Rho-kinase (ROCK) analysis with Western blotting (...) significantly lower in CM than EECS as demonstrated by Western blotting.Given Rho-kinase could take essential roles in cell differentiation, the results of this study implicate that down-regulated Rho-kinase could be responsible for the keratinocyte undifferentiation seen in cholesteatoma pathogenesis.

2017 Otology and Neurotology

97. Intraoperative Bleeding and the Risk of Residual Cholesteatoma: A Multivariate Analysis. (PubMed)

Intraoperative Bleeding and the Risk of Residual Cholesteatoma: A Multivariate Analysis. Residual cholesteatoma most frequently occurs where visualization and surgical access are restricted by anatomic constraints. Other factors that compromise surgical field visualization might also increase rates of residual cholesteatoma. We evaluated whether impaired surgical field clarity from bleeding increases rates of residual cholesteatoma.Prospective cohort study.Tertiary care hospital.Consecutive (...) series of children having intact canal wall surgery for cholesteatoma.Impact of bleeding on surgical field clarity was assessed intraoperatively on a six-point scale.Presence of residual cholesteatoma was established at follow up clinical encounters, second stage procedures, and with magnetic resonance imaging. Multiple logistic regression was used to determine the influence of surgical field clarity and other factors on rates of residual cholesteatoma.Surgery was completed on 232 ears and residual

2017 Otology and Neurotology

98. Incidence, 10-year recidivism rate and prognostic factors for cholesteatoma. (PubMed)

Incidence, 10-year recidivism rate and prognostic factors for cholesteatoma. Cholesteatoma patients have a high risk of recurrence with complications, and knowledge exchange is a prerequisite for improving treatment. This study aimed to apply appropriate statistics to provide meaningful and transferable results from cholesteatoma surgery, to highlight independent prognostic factors, and to assess the incidence rate.Incidence rates were assessed for the district of Aarhus, Denmark. From 147 (...) patients operated on mainly with canal wall up mastoidectomies for debuting cholesteatomas, 10-year Kaplan-Meier recidivism rates were calculated and independent prognostic factors for the recidivism were identified by Cox multivariate regression analyses.Incidence rate was 6.8 per 100 000 per year. The 10-year cumulative recidivism rate was 0.44 (95 per cent confidence interval, 0.37-0.53). Independent prognostic factors for the recidivism were: age below 15 years (hazard ratio = 2.2; p > z = 0.002

2017 Journal of Laryngology & Otology

99. A Rare Case Report and Literature Review of External Auditory Canal Cholesteatoma with Circumferential Destruction of Canal Wall Exposing Facial Nerve (PubMed)

A Rare Case Report and Literature Review of External Auditory Canal Cholesteatoma with Circumferential Destruction of Canal Wall Exposing Facial Nerve External auditory canal cholesteatoma (EACC) is a rare condition with an estimated incidence of 1.2 per 1000 new otological patients. It is often mistaken with keratosis obturans. We discuss an extensive primary EACC with an aural polyp in a male which was managed by modified radical mastoidectomy.

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2017 Case reports in otolaryngology

100. Application of high resolution computer tomography in external ear canal cholesteatoma diagnosis (PubMed)

Application of high resolution computer tomography in external ear canal cholesteatoma diagnosis To evaluate High Resolution Computer Tomography (HRCT) in the diagnosis of external ear canal cholesteatoma.In this retrospective study, HRCTs of 27 patients with external ear canal cholesteatoma were reviewed. The changes in the external ear canal, tympanic membrane (TM), scutum, tympanum and mastoid were measured and categorized.Fourteen patients showed no or mild destruction in the external ear (...) in the stage III group.HRCT can provide detail information about the extent of external ear canal cholesteatoma. Such information can be used to identify special situations with serious complications and to differentiate external ear canal cholesteatoma from middle ear cholesteatoma.

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2017 Journal of otology

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