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Cholesteatoma

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1261. Congenital implantation cholesteatomas of the occipitoparietotemporal junction. (PubMed)

Congenital implantation cholesteatomas of the occipitoparietotemporal junction. Two cases of cranial cholesteatomas centered at the occipitoparietotemporal junction are presented, and 12 similar cases reported as diploic cholesteatomas involving the temporal bone are reviewed. Among the reported diploic cholesteatomas, 3 involved the occipitoparietotemporal junction and had the same clinical characteristics as the ones presented here. These 5 lesions did not produce expansion of the cranial (...) tables, they had a predominantly intracranial growth, and their matrix was bonded to the dura, so that their complete excision was prevented. It is proposed that cranial cholesteatomas involving the occipitoparietotemporal junction arise, not from within the tables of the skull, but from squamous cells trapped during closure of the mastoid fontanelle and formation of the suture. Hence, they should be recognized as having an origin different from that of diploic lesions, and termed congenital

2002 Rhinology and Laryngology

1262. A staging system for congenital cholesteatoma. (PubMed)

A staging system for congenital cholesteatoma. To develop a staging system for congenital cholesteatoma in predicting the likelihood of residual disease.Retrospective analysis of data from a case series, to identify predictors of residual disease.Tertiary care pediatric hospital.Children undergoing surgical removal of congenital cholesteatoma. There were 156 patients, with 160 cholesteatomas; 4 children had bilateral disease.Each case was scored as to quadrants of the middle ear involved (...) , ossicular involvement, and mastoid extension.Surgically confirmed residual disease at any time after the initial procedure.Four stages were defined as follows: stage I, disease confined to a single quadrant; stage II, cholesteatoma in multiple quadrants, but without ossicular involvement or mastoid extension; stage III, ossicular involvement without mastoid extension; and stage IV, mastoid disease. There was a strong association between stage and residual disease, ranging from a 13% risk in stage I

2002 Archives of Otolaryngology Head and Neck Surgery

1263. Evidence for microbial biofilms in cholesteatomas. (PubMed)

Evidence for microbial biofilms in cholesteatomas. Sessile bacteria within biofilms are highly resistant to eradication by antimicrobial agents. Previously, we have shown that the most common organisms cultured from experimentally induced cholesteatomas are biofilm formers. Additionally, the keratin "matrix" of a cholesteatoma is an ideal environment for the support of biofilm formation.To determine if microbial biofilms occur within the keratin matrix of infected cholesteatomas.We evaluated (...) the histomorphologic characteristics of 24 human and 22 experimental cholesteatomas for evidence of biofilm formation using light and transmission electron microscopy.Human tissues were collected during surgical eradication of existing cholesteatomas. Twenty-two gerbil cholesteatomas were either spontaneously occurring or induced by external auditory canal ligation and harvested several months later.Gram-positive and gram-negative bacteria were seen within acellular deposits among the keratin accumulations in 21

2002 Archives of Otolaryngology Head and Neck Surgery

1264. Value of ear endoscopy in cholesteatoma surgery. (PubMed)

Value of ear endoscopy in cholesteatoma surgery. The purpose of this study was to assess the value of ear endoscopy in cholesteatoma surgery and to demonstrate its consequence in improving surgical outcome.A total of 92 ears with acquired cholesteatoma (primary or secondary) were operated on. In this prospective study, 82 cases were operated on by using canal wall up (CWU) technique, and 10 cases were on operated on by using canal wall down (CWD) procedure. Endoscopically guided ear surgery (...) in both CWU and CWD groups, followed by the facial recess and the undersurface of the scutum in the CWU cases. Reconstruction of the hearing mechanism was performed in the primary surgery in 86 cases (93.5%) and postponed to the second stage in only six cases (6.5%). Out of the 82 CWU cases, 35 second-look endoscopic explorations (42.7%) were performed. Three recurrences (8.6%) were identified. Two cases showed a tiny residual cholesteatoma pearl, and the third showed a larger open residual

2002 Otology and Neurotology

1265. Expression of epidermal growth factor, tumor necrosis factor-alpha, and interleukin-1alpha in chronic otitis media with or without cholesteatoma. (PubMed)

Expression of epidermal growth factor, tumor necrosis factor-alpha, and interleukin-1alpha in chronic otitis media with or without cholesteatoma. The object of this study was to compare the expression of epidermal growth factor, interleukin-1alpha, and tumor necrosis factor-alpha in chronic otitis media with or without cholesteatoma.It has been reported that cytokines and epidermal growth factor are effective in the bone resorption process in chronic otitis media. Bone resorption can also occur (...) in chronic otitis media without cholesteatoma. However, comparative analysis is lacking. This issue has been investigated in a blind, controlled and prospective analysis.The activities of interleukin-1alpha, tumor necrosis factor-alpha, and epidermal growth factor were determined by commercially available enzyme-linked immunosorbent assay kits in tissue biopsy samples from 16 patients without cholesteatoma and from 23 patients with cholesteatoma (cholesteatoma epithelium). To establish a control group

2002 Otology and Neurotology

1266. Telomerase activity, telomere length, and apoptosis: a comparison between acquired cholesteatoma and squamous cell carcinoma. (PubMed)

Telomerase activity, telomere length, and apoptosis: a comparison between acquired cholesteatoma and squamous cell carcinoma. Cholesteatoma disease is characterized by accumulation of keratinizing epithelium. Several molecular markers of tumor formation have been found in cholesteatoma (e.g. upregulation of matrix metalloproteinases, c and activation of angiogenesis). Other molecular findings clearly distinguish between cholesteatoma and malignant tumors (e.g., lack of chromosomal instability (...) , intact checkpoint responses). To further distinguish the molecular mechanisms in cholesteatoma from malignant tumors, the authors determined telomerase activity and telomere length in both tissue types.To evaluate the role of telomerase activation and telomere length in cholesteatoma, 29 cholesteatoma samples and 9 squamous cell carcinomas were analyzed for telomerase activity and telomere length. In addition, the rate of apoptosis was determined in both groups, using the TdT-mediated dUTP nick end

2002 Otology and Neurotology

1267. Cartilage palisade tympanoplasty in sinus and tensa retraction cholesteatoma. (PubMed)

Cartilage palisade tympanoplasty in sinus and tensa retraction cholesteatoma. The aim of this study was to investigate whether reconstruction of the eardrum with palisade cartilage technique could prevent retraction of the new eardrum after surgery for sinus and tensa retraction cholesteatoma in children and to investigate the postoperative hearing.In 32 children aged 5 to 15 years, operated on from June 1995 to October 2000 for cholesteatoma (21 with sinus cholesteatoma and 11 with tensa (...) retraction cholesteatoma) the eardrum was reconstructed with the palisade cartilage technique. Postoperatively, the children were seen as outpatients and were recently reevaluated with otomicroscopy, tympanometry, and audiometry. All patients (100%) were reevaluated on an average of 37 months (range 3-63 months).Postoperative retractions, perforations, cholesteatoma recurrence, and hearing.At the final examination, posterosuperior retraction was observed in two patients, both operated on for sinus

2002 Otology and Neurotology

1268. Increased proliferation and migration of epithelium in advancing experimental cholesteatomas. (PubMed)

Increased proliferation and migration of epithelium in advancing experimental cholesteatomas. Hyperproliferative and migratory process of keratinocytes are part of the pathogenesis of cholesteatoma.Cytokeratin (CK) changes were prominent in the most rapidly expanding regions of cholesteatoma formation.The three types of animal model-canal ligation (CL), retraction pocket (RP), and propylene glycol (PG)-were induced in Mongolian gerbils. The monoclonal antibodies to CK1/10, CK5/6, and CK13/16 (...) were used for immunohistochemistry. The intensity of immunostaining in the pars tensa of the tympanic membrane was measured using the densitometry and compared with respect to the stage of cholesteatoma and the type of animal model.With cholesteatoma formation, CK expressions were significantly increased at the peripheral part of the pars tensa, the expanding part of cholesteatoma. Among the CKs tested, the prominent changes were observed in expression of CK13/16, a marker for hyperproliferation

2002 Otology and Neurotology

1269. A study of prevalence of cholesteatoma in complications of suppurative otitis media (PubMed)

A study of prevalence of cholesteatoma in complications of suppurative otitis media Complications of suppurative otitis media are common in developing world. Cholesteatoma has been implicated as the causative factor. We studied 76 cases of suppurative otitis media presented with complica tions and found that only 64% cases had cholesteatoma. Granulation were present in most of the cases of intracranial complications (16.68%).

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1998 Indian Journal of Otolaryngology and Head & Neck Surgery

1270. Keratin Particle-Induced Osteolysis: A Mouse Model of Inflammatory Bone Remodeling Related to Cholesteatoma (PubMed)

Keratin Particle-Induced Osteolysis: A Mouse Model of Inflammatory Bone Remodeling Related to Cholesteatoma We implanted keratin and poly(methyl methacrylate) (PMMA) particles to the surface of mouse calvariae to produce a quantitative, localized, inflammatory bone remodeling similar to that seen in cholesteatoma. Both types of particles resulted in increased osteoclast density compared with controls. Osteoclasts infiltrated from marrow and vascular spaces and were active at the periphery (...) of these spaces leading to significant bone remodeling, as demonstrated by the incorporation of bone-labelling fluorophores. Osteoclasts were rarely found on the surface of the calvariae, and mineral apposition rate at the ventral surface was not altered in keratin-implanted animals compared with nonoperated controls. While not useful for the study of the root cause of cholesteatoma, this model will allow the study ofpathologic bone remodeling related to cholesteatoma in a genetically defined animal.

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2001 JARO: Journal of the Association for Research in Otolaryngology

1271. 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 Controlled trial quality: uncertain

1272. [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 Controlled trial quality: uncertain

1273. 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 Controlled trial quality: uncertain

1274. Canal wall down tympanoplasty with canal reconstruction for middle-ear cholesteatoma: post-operative hearing, cholesteatoma recurrence, and status of re-aeration of reconstructed middle-ear cavity. (PubMed)

Canal wall down tympanoplasty with canal reconstruction for middle-ear cholesteatoma: post-operative hearing, cholesteatoma recurrence, and status of re-aeration of reconstructed middle-ear cavity. The post-operative outcome of hearing, the reconstructed external auditory canal, and the state of the reconstructed middle-ear cavity after canal wall down tympanoplasty with canal and attico-antrum reconstruction was studied in 103 ears with middle-ear cholesteatoma. The reconstructed mastoid (...) cavity was re-aerated in 36.5 per cent of the cases, which was significantly lower than for the epitympanum (63.5 per cent) and tympanic cavity (82.4 per cent). Tympanoplasty was successful in terms of hearing results in 68.9 per cent of all subjects and in 75.4 per cent of the ears having a re-aerated tympanic cavity, which was significantly better than the 38.5 per cent for ears in which the tympanic cavity was not re-aerated. The findings of recurrent cholesteatoma, tympanic atelectasis

2003 Journal of Laryngology & Otology

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