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Cholesteatoma

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1241. Classification of the external auditory canal cholesteatoma. (PubMed)

Classification of the external auditory canal cholesteatoma. The external auditory canal cholesteatoma (EACC) is a rare disease in the field of otolaryngology. Only 1 in 1,000 new otologic patients present with this entity, which was first described by Toynbee. The aim of this article is to classify EACC by different histopathologic and clinical findings of patients presenting to the Department of Otolaryngology at the University of Mannheim, Germany.From 2000 to 2004, 17 patients presented (...) to our clinic with EACC. The cholesteatoma were treated surgically, and the specimens were investigated histologically. Clinical findings were also recorded. We classified four stages: stage I with hyperplasia of the canal epithelium, stage II including periosteitis, Stage III including a defective bony canal, and stage IV showing an erosion of adjacent anatomic structure.Eight patients presented with stage II, five patients with stage III, three with stage I, and only one patient presented

2005 Laryngoscope

1242. A new experimental model of acquired cholesteatoma. (PubMed)

A new experimental model of acquired cholesteatoma. Cholesteatoma is a recurrent disease that is difficult control by otologists. This study aims to develop an experimental model of cholesteatoma that is easy to reproduce, using latex to induce the inflammatory reaction and propylene glycol as the foreign body in the middle ear.We used a new experimental model in which an intentional perforation was performed on the tympanic membrane of rats, followed by the introduction of a latex (...) biomembrane.A control group was submitted only to perforation of the tympanic membrane. Propylene glycol with latex was used in experimental group 1 and latex alone in experimental group 2. The rats were killed during the eighth week and their tympanic bullae were stained with hematoxylin and eosin.Eighty percent of the animals in group 1 and 90% in group 2 developed a cholesteatoma. No formation of cholesteatomas or inflammatory tissue occurred in the control group.The presence of inflammatory cells may

2005 Laryngoscope

1243. Usefulness of delayed postcontrast magnetic resonance imaging in the detection of residual cholesteatoma after canal wall-up tympanoplasty. (PubMed)

Usefulness of delayed postcontrast magnetic resonance imaging in the detection of residual cholesteatoma after canal wall-up tympanoplasty. Imaging takes an increasing place in the follow-up of patients who have undergone surgery for cholesteatoma, with computed tomography (CT) as the first line imaging technique. However, in case of complete opacity of the tympanomastoid cavities, CT is not able to differentiate residual cholesteatoma from postoperative scar tissue. The aim of this study (...) was to assess the usefulness of magnetic resonance imaging (MRI) using delayed postcontrast T1-weighted images for the detection of residual cholesteatoma after canal wall-up tympanoplasty (CWU) in cases where CT was not conclusive.Prospective study.MRI, with delayed postcontrast T1-weighted images (30-45 minutes after contrast injection), was performed before revision surgery in 41 consecutive patients who had undergone CWU for cholesteatoma and presenting with a nonspecific complete opacity of the mastoid

2005 Laryngoscope

1244. Creation of a cholesteatoma model using three-dimensional cultured skin equivalents. (PubMed)

Creation of a cholesteatoma model using three-dimensional cultured skin equivalents. Recent years have seen success in establishing methods for cell culture that lead to the creation of a three-dimensional tissue architecture, and this represents a great advance for the ability to carry out research in vitro. Accordingly, the present studies were carried out with the objective of using three-dimensional cultured skin equivalents for the in vitro creation of a model of middle ear cholesteatoma (...) , something that has heretofore been considered to be very difficult.A cholesteatoma model was created in vitro, and discussion is presented regarding the immigration theory and the retraction theory that have been proposed as explanations of the causation of cholesteatoma.Cultured skin equivalents were prepared, followed by creation of an epidermal and dermal defect in them. Then, the changes in the epidermis were investigated histologically. In addition, immunohistochemical studies were performed

2005 Laryngoscope

1245. Congenital cholesteatoma of the mastoid temporal bone. (PubMed)

Congenital cholesteatoma of the mastoid temporal bone. Congenital mastoid cholesteatomas are rare lesions of the temporal bone. The clinical presentation of these lesions is variable, making them difficult to identify preoperatively. We evaluated our series of mastoid congenital cholesteatomas (CCs) in an effort to better define the clinical presentation, imaging characteristics, and surgical challenges specific to this lesion.Retrospective chart and radiologic study review.The medical records (...) , ossicular destruction, facial nerve exposure, and associated postauricular abscess. Management of these lesions is reviewed.Congenital mastoid cholesteatomas have a variable and nonspecific clinical presentation. Surgical challenges arise from the indolent nature of this clinical entity, which belies the extent of otologic involvement. Imaging with CT and magnetic resonance imaging are diagnostic, defines the extent of these lesions, and facilitates preoperative surgical planning.

2007 Laryngoscope

1246. Intracranial cholesteatoma: a case report and review. (PubMed)

Intracranial cholesteatoma: a case report and review. A cholesteatoma can be a complication of ear infection, eustachian tube dysfunction, prior ear surgery, or tympanic membrane perforation. It is typically associated with otorrhea and conductive hearing loss; sensorineural hearing loss, dysequilibrium, facial nerve paralysis, and altered mental status signify advanced disease. The treatment is surgical and recurrences are common. A case of cholesteatoma is presented that was associated

2007 Journal of Emergency Medicine

1247. Staged tympanostomy tube placement facilitates pediatric cholesteatoma management. (PubMed)

Staged tympanostomy tube placement facilitates pediatric cholesteatoma management. Evaluate results of middle ear ventilation with or without adenoidectomy prior to definitive cholesteatoma surgery in children with concomitant middle ear effusion.Charts of 40 children seen in follow-up for acquired or congenital cholesteatoma were reviewed. Nine children underwent staged tympanostomy tube placement for concomitant middle ear effusion. Computed tomography was obtained after placement of tubes (...) in all patients. Extent of disease by tomography was compared to disease extent at definitive surgery. Details of cholesteatoma surgeries, most recent disease status, and length of follow-up were recorded.Three children had extensive congenital cholesteatoma, while six had acquired disease. All nine children underwent tube placement (four with adenoidectomy) prior to definitive surgery. Computed tomography obtained after middle ear ventilation accurately predicted extent of cholesteatoma involvement

2007 International Journal of Pediatric Otorhinolaryngology

1248. Diagnosis of pediatric cholesteatoma. (PubMed)

Diagnosis of pediatric cholesteatoma. Cholesteatomas are abnormal collections of squamous epithelium and keratin debris that usually involve the middle ear and mastoid. Although histologically benign, they have the ability to expand and destroy bone. Cholesteatomas are treated surgically. The success of such surgery is highly dependent on the extent of the lesion. This article presents information and images to aid the general pediatrician in the early recognition of cholesteatomas, both

2007 Pediatrics

1249. Cholesteatoma and Otosclerosis: Two slowly progressive causes of hearing loss treatable through corrective surgery (PubMed)

Cholesteatoma and Otosclerosis: Two slowly progressive causes of hearing loss treatable through corrective surgery 15931303 2005 11 07 2018 11 13 1539-4182 1 2 2003 Apr Clinical medicine & research Clin Med Res Cholesteatoma and otosclerosis: two slowly progressive causes of hearing loss treatable through corrective surgery. 151-4 Holt James J JJ Department of Otolaryngology-Head and Neck Surgery, Marshfield Clinic, Marshfield, Wisconsin 54449, USA. holt.james@marshfieldclinic.org eng Journal (...) Article Review United States Clin Med Res 101175887 1539-4182 IM Cholesteatoma, Middle Ear complications physiopathology surgery Hearing Loss etiology physiopathology surgery Humans Otosclerosis complications physiopathology surgery Stapes Surgery 10 2003 03 17 2003 03 20 2005 6 3 9 0 2005 11 8 9 0 2005 6 3 9 0 ppublish 15931303 PMC1069039 Otol Neurotol. 2001 Nov;22(6):723-30 11698787 Otolaryngol Head Neck Surg (1979). 1979 Jan-Feb;87(1):60-5 503472 Otolaryngol Clin North Am. 1989 Oct;22(5):967-79

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2003 Clinical Medicine and Research

1250. Rhinitis caseosa, nasal cholesteatoma and allergic fungal sinusitis (PubMed)

Rhinitis caseosa, nasal cholesteatoma and allergic fungal sinusitis The recently described Syndrome of Allergic Fungal Sinusitis (AFS) has many similarities with the previously described entity of rhinitis Caseosa (synonym-Nasal Cholesteatoma). 28 patients treated over a 6 year period with a diagnosis of rhinitis caseosa/nasal cholesieatoma have been retrospectively reviewed with regard to their clinical and radiological features, operative findings and microbiologic and histopathologual

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2003 Indian Journal of Otolaryngology and Head & Neck Surgery

1251. Diffusion-weighted MR imaging sequence in the detection of postoperative recurrent cholesteatoma. (PubMed)

Diffusion-weighted MR imaging sequence in the detection of postoperative recurrent cholesteatoma. To prospectively evaluate a fast spin-echo (SE) diffusion-weighted sequence for magnetic resonance (MR) imaging of recurrent cholesteatoma in patients who have undergone middle ear surgery.The study was approved by the institutional review board, and informed consent was obtained from all patients. Twenty-four patients (10 female and 14 male patients; mean age, 44 years) who had undergone resection (...) of cholesteatoma were referred for MR imaging. MR imaging was performed with a 1.5-T unit by using unenhanced diffusion-weighted fast SE imaging at b factors of 0 and 800 sec/mm(2), unenhanced T2-weighted fast SE imaging, unenhanced T1-weighted SE imaging, and delayed contrast material-enhanced T1-weighted imaging. Two radiologists evaluated the diffusion-weighted fast SE images for the presence of a high-signal-intensity cholesteatoma. Results from MR imaging were compared with reports from second- or third

2006 Radiology

1252. Late recurrence of renal cholesteatoma after 15 years. (PubMed)

Late recurrence of renal cholesteatoma after 15 years. We report a late recurrence of a cholesteatoma of the left kidney after 15 years. Both the initial case and the recurrence were treated by endourologic and percutaneous approaches.

2004 Urology

1253. Transforming Growth Factor beta and Wound Healing in Human Cholesteatoma. (PubMed)

Transforming Growth Factor beta and Wound Healing in Human Cholesteatoma. Cholesteatoma is a nonmalignant, destructive lesion of the temporal bone that gradually expands and causes complications by the erosion of the adjacent bony structures. The consequences can be as severe as facial paralysis and intracranial complications. Until now, surgery has been the only treatment of choice. The pathogenesis of cholesteatoma remains controversial. Current concepts postulate that cholesteatoma may (...) system.In 12 cholesteatoma and control samples, protein expressions showed consistent relationships among TGFbeta, nuclear pSmad2, and Smad7. We found concordant expressions of TGFbeta and nuclear pSmad2 in cholesteatoma epithelium and its control. Epithelial Smad7 expression was significantly reduced in cholesteatoma when compared with control epithelium (P = .04). In cholesteatoma extracellular matrix (ECM), a significantly increased TGFbeta, and nuclear pSmad2 was demonstrated (P < .01). Smad7

2007 Laryngoscope

1254. Aural polyps as predictors of underlying cholesteatoma. (PubMed)

Aural polyps as predictors of underlying cholesteatoma. In a retrospective study of 96 patients 16 different histological features were examined in 100 aural polyps to see whether some or any could be used to predict the presence or absence of a cholesteatoma underlying the polyp. The patients were divided into those who had cholesteatoma and those who did not, so that discriminatory features were identified. These were combined to make an overall prediction of the probability (...) of a cholesteatoma in the middle ear. The results showed that any polyp that (i) was composed of raw granulation tissue and (ii) contained keratin as flakes or masses had a 70-80% probability of being associated with an underlying cholesteatoma. In contrast, when a polyp (i) was composed of a fibrous core, (ii) had a covering epithelium, and (iii) contained glands and lymphoid aggregates, there was a 70-80% probability of cholesteatoma being absent. This scoring system can be used to help surgeons decide whether

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1989 Journal of Clinical Pathology

1255. Cholesteatoma: skin in the wrong place. (PubMed)

Cholesteatoma: skin in the wrong place. 9068441 1997 03 28 2018 11 13 0141-0768 90 2 1997 Feb Journal of the Royal Society of Medicine J R Soc Med Cholesteatoma: skin in the wrong place. 93-6 Robinson J M JM Gloucester Royal Hospital, England. eng Journal Article Review England J R Soc Med 7802879 0141-0768 IM Bone Transplantation Cholesteatoma, Middle Ear surgery Ear, Middle surgery Humans Tympanoplasty 28 1997 2 1 1997 2 1 0 1 1997 2 1 0 0 ppublish 9068441 PMC1296148 Arch Otolaryngol. 1969

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1997 Journal of the Royal Society of Medicine

1256. Advantages of Endoscopically Assisted Surgery for Attic Cholesteatoma (PubMed)

Advantages of Endoscopically Assisted Surgery for Attic Cholesteatoma Combined use of an operating microscope and a middle ear endoscope seems to be helpful for selecting an appropriate surgical technique and for identifying more patients in whom cholesteatoma can be removed by a trans-canal approach alone. To investigate whether attic cholesteatoma can be treated by a trans-canal approach alone, a review was performed of patients who had undergone endoscopically assisted tympanoplasty (...) and the outcome of surgery was compared with the preoperative CT findings. Using a rigid endoscope (3 mm in diameter and 6 cm in length with a viewing angle of 30 degrees ), twenty eight patients were examined to determine whether total resection of the cholesteatoma was possible by trans-canal atticotomy alone. According to the CT findings, total resection of cholesteatoma was possible by trans-canal atticotomy combined with the use of a rigid endoscope not only in 4 patients with the shadow localized

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2001 Diagnostic and therapeutic endoscopy

1257. Medical management of chronic suppurative otitis media without cholesteatoma in children. (PubMed)

Medical management of chronic suppurative otitis media without cholesteatoma in children. To determine whether systemic administration of antibiotics may eliminate or reduce the need for tympanomastoid surgery in chronic suppurative otitis media without cholesteatoma, we undertook a randomized, prospective study comparing three regimens: (1) daily suction and débridement, with intravenous administration of mezlocillin until 3 days after the discharge stopped, (2) daily suction and débridement (...) , the duration of drainage before initiation of antibiotic therapy, or prophylaxis. We conclude that intravenous wide-spectrum antibiotic therapy in conjunction with daily suction and débridement is efficacious for the treatment of chronic suppurative otitis media without cholesteatoma.

1990 The Journal of pediatrics

1258. Pathogenesis of attic cholesteatoma: clinical and immunohistochemical support for combination of retraction theory and proliferation theory. (PubMed)

Pathogenesis of attic cholesteatoma: clinical and immunohistochemical support for combination of retraction theory and proliferation theory. The aim of the current study was to provide support for a combination of the retraction and proliferation theories of acquired cholesteatoma.There is clinical evidence for formation of a retraction, but there is a lack of explanation for the transition from a retraction pocket to an active and expanding attic cholesteatoma.Epidemiologic studies (...) on the incidence of attic retractions and follow-up studies on patients with attic retractions were performed. Additionally, expression of proliferation marker and analysis of basement membrane were studied in samples of attic cholesteatoma.The prevalence of attic retractions was between 14% and 25% of investigated ears. In children with manifest secretory otitis, there were some attic cholesteatomas and 5% to 6% severe retractions. Some of them became precholesteatomas, requiring treatment and controls

2000 The American journal of otology

1259. [Multicenter study comparing the efficacy and tolerance of topical ciprofloxacin (0.3%) versus topical gentamicin (0.3%) in the treatment of simple, non-cholesteatomaous chronic otitis media in the suppurative phase]. (PubMed)

[Multicenter study comparing the efficacy and tolerance of topical ciprofloxacin (0.3%) versus topical gentamicin (0.3%) in the treatment of simple, non-cholesteatomaous chronic otitis media in the suppurative phase]. A multicentre double-blind randomized study was carried out to compare topical ciprofloxacin and topical gentamicin in the treatment of simple non-cholesteatomatous purulent chronic otitis media. Three hundred and eight patients were included in the study, 159 treated

1995 Anales otorrinolaringológicos ibero-americanos

1260. Efficacy of mastoid cortex plasty for middle ear aeration in intact canal wall tympanoplasty for cholesteatoma. (PubMed)

Efficacy of mastoid cortex plasty for middle ear aeration in intact canal wall tympanoplasty for cholesteatoma. To determine the effect of closing the bone defect of the mastoid cortex using bone pate after mastoidectomy (mastoid cortex plasty) during the first-stage operation for the restoration of the mastoid cavity aeration.This was a prospective study.Tertiary medical center.Thirty-five patients with cholesteatoma invading the mastoid cavity.Seventeen patients received mastoid cortex plasty (...) with scutum plasty and insertion of a Silastic sheet after removal of the cholesteatoma using a combined approach during the first-stage operation. The 18 control patients received only scutum plasty with the insertion of a Silastic sheet without mastoid cortex plasty during the first-stage operation.The restoration of the middle ear aeration was assessed with high-resolution computed tomography before both the first-stage operation and the second-stage operation.The range of middle ear aeration

2002 Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

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