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Cholesteatoma

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141. Management of pediatric cholesteatoma based on presentations, complications, and outcomes. (PubMed)

Management of pediatric cholesteatoma based on presentations, complications, and outcomes. To highlight important aspects and paradigms in the management of paediatric cholesteatoma in a developing world setting.A retrospective audit was conducted of paediatric cholesteatomas that underwent tympanomastoid surgery between 2008 and 2012 at the Red Cross War Memorial Children's Hospital in Cape Town. The following was audited: initial presentation; cholesteatoma complications; types of surgery (...) , intraoperative findings and outcomes of surgery in terms of hearing, otorrhoea and recidivism; and the reliability of follow-up and how this might influence the type of surgery.Fifty-seven children aged 2-13 years with 61 cholesteatomas (4 bilateral) were reviewed. Fifty-five mastoidectomies were done; 11% presented with complicated cholesteatoma. Referrals from primary care were significantly delayed (>6 months) in 76%. Canal wall down surgery was done in 71%. Forty-five percent had improved hearing (within

2016 International Journal of Pediatric Otorhinolaryngology

142. Fusion of Computed Tomography and PROPELLER Diffusion-Weighted Magnetic Resonance Imaging for the Detection and Localization of Middle Ear Cholesteatoma. (PubMed)

Fusion of Computed Tomography and PROPELLER Diffusion-Weighted Magnetic Resonance Imaging for the Detection and Localization of Middle Ear Cholesteatoma. A method to optimize imaging of cholesteatoma by combining the strengths of available modalities will improve diagnostic accuracy and help to target treatment.To assess whether fusing Periodically Rotated Overlapping Parallel Lines With Enhanced Reconstruction (PROPELLER) diffusion-weighted magnetic resonance imaging (DW-MRI (...) ) with corresponding temporal bone computed tomography (CT) images could increase cholesteatoma diagnostic and localization accuracy across 6 distinct anatomical regions of the temporal bone.Case series and preliminary technology evaluation of adults with preoperative temporal bone CT and PROPELLER DW-MRI scans who underwent surgery for clinically suggested cholesteatoma at a tertiary academic hospital. When cholesteatoma was encountered surgically, the precise location was recorded in a diagram of the middle ear

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2016 JAMA otolaryngology-- head & neck surgery

143. Reexamination of Etiology and Surgical Outcome in Patient With Advanced External Auditory Canal Cholesteatoma. (PubMed)

Reexamination of Etiology and Surgical Outcome in Patient With Advanced External Auditory Canal Cholesteatoma. To describe the etiology of advanced cases of external auditory canal (EAC) cholesteatoma (EACC), and to report the surgical management and outcomes based on canalplasty depending on the extent of adjacent structures involvement around the EAC.Retrospective case review.University hospital.Participants comprised 28 patients (12 males, 16 females) ranging in age from 9 to 86 years old (...) to the jugular bulb, multi-layered repair including bone paste, post-auricular pedicled musculo-periosteal flap, auto cartilage, and temporalis muscle fascia were required. Five patients required revision surgery (17%), including one case of recurrent (reconstructed) cholesteatoma and three cases of perforation of the tympanic membrane.In the majority of our series, underlying diseases followed with microangiopathy and angiogenesis could be possible candidates in the etiology of EACC. Enlarged bony

2016 Otology and Neurotology

144. Clinical characteristics of pediatric external auditory canal cholesteatoma. (PubMed)

Clinical characteristics of pediatric external auditory canal cholesteatoma. External auditory canal cholesteatoma (EACC) is caused by an invasion of squamous tissue into a localized area of periosteitis in the bony canal wall. The clinical characteristics of pediatric EACC are still unknown because of its rare occurrence. To date, only a single paper has reported that pediatric EACC has a less aggressive growth pattern compared to adult EACC. Further studies are required to understand

2016 International Journal of Pediatric Otorhinolaryngology

145. Expressions of isopeptide bonds and corneodesmosin in middle ear cholesteatoma. (PubMed)

Expressions of isopeptide bonds and corneodesmosin in middle ear cholesteatoma. Isopeptide bonds form cross-links between constituent proteins in the horny layer of the epidermis. Corneodesmosin (CDSN) is a major component of corneodesmosomes, which bind corneocytes together. Both play important roles in maintaining epidermal barrier functions. In the present study, we investigated the expressions of isopeptide bonds, CDSN, and related enzymes in middle ear cholesteatoma in comparison (...) with the skin.Prospective case series of patients with middle ear cholesteatoma.Tertiary medical institute.Cholesteatoma and normal postauricular skin were collected from patients with acquired middle ear cholesteatoma during tympanomastoidectomy.Expression of e-(g-glutamyl)lysine isopeptide bonds was examined by immunohistochemistry; Expressions of transglutaminase (TGase)1, TGase2, TGase3, and TGase5 by immunohistochemistry and quantitative RT-PCR (qRT-PCR); expression of CDSN by immunohistochemistry, qRT-PCR

2016 Clinical Otolaryngology

146. TREM-2 promotes acquired cholesteatoma-induced bone destruction by modulating TLR4 signaling pathway and osteoclasts activation (PubMed)

TREM-2 promotes acquired cholesteatoma-induced bone destruction by modulating TLR4 signaling pathway and osteoclasts activation Triggering receptor expressed on myeloid cells (TREM) has been broadly studied in inflammatory disease. However, the expression and function of TREM-2 remain undiscovered in acquired cholesteatoma. The expression of TREM-2 was significantly higher in human acquired cholesteatoma than in normal skin from the external auditory canal, and its expression level (...) was positively correlated with the severity of bone destruction. Furthermore, TREM-2 was mainly expressed on dendritic cells (DCs). In human acquired cholesteatoma, the expression of proinflammatory cytokines (IL-1β, TNF-α and IL-6) and matrix metalloproteinases (MMP-2, MMP-8 and MMP-9) were up-regulated, and their expression levels were positively correlated with TREM-2 expression. Osteoclasts were activated in human acquired cholesteatoma. In an animal model, TREM-2 was up-regulated in mice

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2016 Scientific reports

147. Cochlear implant and congenital cholesteatoma (PubMed)

Cochlear implant and congenital cholesteatoma The occurence of cholesteatoma and cochlear implant is rare. Secondary cholesteatomas may develop as a result of cochlear implant surgery. Primarily acquired cholesteatoma is not typically associated with congenital sensorineural hearing loss or cochlear implant in children. The occurrence of congenital cholesteatoma during cochlear implant surgery has never been reported before, partly because all patients are preoperatively submitted to imaging (...) studies which can theoretically exclude the disease.We have reported a rare case of congenital cholesteatoma, found during sequential second side cochlear implantation in a 3-year-old child. The child underwent a computed tomography (CT) scan and magnetic resonance imaging (MRI) at 12 months of age, before the first cochlear implant surgery, which excluded middle ear pathology. The mass was removed as an intact pearl, without visible or microscopic violation of the cholesteatoma capsule. All the areas

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2016 Journal of Otolaryngology - Head & Neck Surgery

148. Is There A Systemıc Inflammatory Effect of Cholesteatoma? (PubMed)

Is There A Systemıc Inflammatory Effect of Cholesteatoma? Introduction Inflammation causes squamous epithelial transformation of the mucosa in the middle ear cavity and plays a role in the onset, growth, spread, and recurrence of cholesteatoma. Objectives The objective of this study is to investigate the systemic inflammatory effect in chronic otitis with cholesteatoma. Methods The study included a total of 311 patients comprising 156 patients with a pathology diagnosis of cholesteatoma (...) and a control group of 155 with no active inflammation. The Neutrophil-to-lymphocyte Ratio (NLR) was calculated by dividing the neutrophil value by the lymphocyte value. Results The mean NLR was 1.94 ± 0.91 in the patients with cholesteatoma and 1.94 ± 0.85 in the control group. We determined no statistically significant difference between the groups in respect of NLR (p = 0.983). We calculated the NLR as 2.01 ± 1.00 in patients with ossicle erosion and 1.82 ± 0.69 in those without ossicle erosion, 1.86

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2016 International archives of otorhinolaryngology

149. Efficacy of antibiotic prophylaxis prior to tympanoplasty for contaminated cholesteatoma. (PubMed)

Efficacy of antibiotic prophylaxis prior to tympanoplasty for contaminated cholesteatoma. To evaluate the efficacy of combined antistaphylococcal and antipseudomonal preoperative antibiotics for preventing surgical site infections following tympanoplasty and mastoidectomy with contaminated cholesteatoma.Retrospective chart review.Medical records of patients who underwent tympanoplasty ± mastoidectomy for cholesteatoma were reviewed. Only cases considered to have contaminated or dirty surgical (...) a surgical site infection rate of 11%, and those treated with perioperative antibiotics had a rate of 1% (P = 0.02).Administration of preoperative antibiotics to cover staphylococcal and pseudomonal species may prevent surgical site infections with tympanoplasty ± mastoidectomy for contaminated cholesteatoma.4. Laryngoscope, 126:2363-2366, 2016.© 2016 The American Laryngological, Rhinological and Otological Society, Inc.

2016 Laryngoscope

150. Cholesteatoma

Cholesteatoma Cholesteatoma - NICE CKS Clinical Knowledge Summaries Share Cholesteatoma: Summary A cholesteatoma is an abnormal sac of keratinizing squamous epithelium and accumulation of keratin within the middle ear or mastoid air cell spaces that can become infected and also erode neighbouring structures. A general practitioner with a list size of 2500 patients would expect to see, on average, one new case of cholesteatoma every 4–5 years. Cholesteatoma may be asymptomatic in its early (...) stages. Cholesteatoma most commonly presents with a persistent or recurrent discharge from the ear that is often foul smelling. Additionally, a conductive hearing loss may occur (although it is commonly not noticed) as well as ear discomfort (although this is usually mild and not a prominent feature of the condition). Rarely with progression of the disease vertigo, sensorineural hearing loss, facial nerve palsy, meningitis or intracranial abscess may develop. The diagnosis requires clear

2014 NICE Clinical Knowledge Summaries

151. Cholesteatoma in ectopic kidney (PubMed)

Cholesteatoma in ectopic kidney Cholesteatoma in the urinary system is a rarely seen benign condition. Rosina firstly defined this condition in the year 1953. Histopathologically it is characterized with keratinization, and squamous metaplasia of urothelial epithelium associated with desquamation of keratinized layers. Flank pain is the most common symptom that is caused by elimination of keratinous material. In our case we will discuss cholesteatoma developed in an ectopic kidney which has

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2016 Turkish journal of urology

152. The presentation and management of giant cholesteatoma: a systematic review and case report

The presentation and management of giant cholesteatoma: a systematic review and case report Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address

2018 PROSPERO

153. Expression levels of receptor activator of nuclear factor-κB ligand and osteoprotegerin are associated with middle ear cholesteatoma risk.

Expression levels of receptor activator of nuclear factor-κB ligand and osteoprotegerin are associated with middle ear cholesteatoma risk. Overexpression of receptor activator of nuclear factor-κB ligand (RANKL) and low expression of osteoprotegerin (OPG) are typical features in middle ear cholesteatoma patients. The altered RANKL/OPG protein ratio suggests that alterations in the RANKL-OPG pathway may be major factors in the pathogenesis of middle ear cholesteatoma.Our meta-analysis explored (...) on the correlation of RANKL and OPG expression with middle ear cholesteatoma. Increased RANKL expression positively correlated with middle ear cholesteatoma, while OPG expression showed an inverse association (p < 0.05). The ratio of RANKL/OPG in middle ear cholesteatoma cases was higher than in healthy controls, indicating that our observations are applicable to each individual case. Subgroup analysis based on country of study revealed that OPG levels decreased in China and Korea, and high RANKL expression

2015 Acta oto-laryngologica

154. The Bony Obliteration Tympanoplasty in Pediatric Cholesteatoma: Long-term Safety and Hygienic Results. (PubMed)

The Bony Obliteration Tympanoplasty in Pediatric Cholesteatoma: Long-term Safety and Hygienic Results. To present the safety and hygienic results of a 5-year longitudinal study in a pediatric population undergoing surgery for extensive cholesteatoma using a canal wall up approach with bony obliteration of the mastoid and epitympanic space.Retrospective consecutive study.Thirty-three children (≤18 yr) undergoing surgery for cholesteatoma (34 ears) between 1997 and 2009.Therapeutic.Tertiary (...) referral center.1) Residual and recurrent cholesteatoma rates at 5-year postsurgery, 2) postoperative waterproofing and hygienic status of the ear, and 3) required operation rate to achieve the safety and hygienic goals.At 5 years no patients were lost in follow-up. This consecutive series design is rare in chronical otitis media treatment reporting. The standard residual rate at 5 years was 5.8%, representing two residual cholesteatomas in the middle ear. The standard recurrence rate at 5 years

2015 Otology and Neurotology

155. Does Checking the Placement of Ossicular Prostheses via the Posterior Tympanotomy Improve Hearing Results After Cholesteatoma Surgery? (PubMed)

Does Checking the Placement of Ossicular Prostheses via the Posterior Tympanotomy Improve Hearing Results After Cholesteatoma Surgery? Posterior tympanotomy (PT) is often performed during the surgical management of middle ear cholesteatoma with extension in the retrotympanum area. This PT can also be used to control the right position of the ossicular prosthesis masked by the tympanic membrane reconstruction.To compare audiologic results after ossiculoplasty performed via the outer ear canal (...) and via the PT for patients with cholesteatoma.Retrospective chart reviews were performed for 68 patients (68 ears) with cholesteatoma who underwent titanium ossicular prosthesis surgery between January 2007 and January 2011. We compared audiologic results between two groups: the WPT group (the group without checking the prosthesis via the PT) and the PT group (the group with placing and/or checking the prosthesis via the PT). A postoperative pure-tone average air-bone gap of 20 dB or less

2015 Otology and Neurotology

156. Residual Cholesteatoma After Endoscope-guided Surgery in Children. (PubMed)

Residual Cholesteatoma After Endoscope-guided Surgery in Children. Endoscopes can facilitate surgery within tympanomastoid recesses that are not visible with the operating microscope. This study investigates whether use of endoscopes to guide dissection of cholesteatoma leads to lower rates of residual cholesteatoma than using the endoscope only for inspection after microscope-guided dissection.Comparative cohort study.Tertiary pediatric center.Two hundred thirty-five patients with acquired (...) or congenital cholesteatoma in children <18 years having intact canal wall surgery and follow-up >12 months.Comparison of group (A) microscope surgery followed by endoscopic inspection, with group (B) endoscope-guided dissection.Residual cholesteatoma rates, controlling for site of initial cholesteatoma, detection by second-stage surgery, and length of follow-up.Analysis of all patients showed endoscopic dissection was associated with less residua in the middle ear (risk difference = 0.12; p = 0.026, Kaplan

2015 Otology and Neurotology

157. A Systematic Review of Non-Echo Planar Diffusion-Weighted Magnetic Resonance Imaging for Detection of Primary and Postoperative Cholesteatoma. (PubMed)

A Systematic Review of Non-Echo Planar Diffusion-Weighted Magnetic Resonance Imaging for Detection of Primary and Postoperative Cholesteatoma. To investigate the diagnostic value of non-echo planar diffusion-weighted magnetic resonance imaging (DW-MRI) for primary and recurrent/residual (postoperative) cholesteatoma in adults (≥18 years) after canal wall up surgery.We conducted a systematic search in PubMed, Embase, and Cochrane up to October 22, 2014.All studies investigating non-echo planar (...) DW-MRI for primary and postoperative cholesteatoma were selected and critically appraised for relevance and validity.In total, 779 unique articles were identified, of which 23 articles were included for critical appraisal. Seven articles met our criteria for relevance and validity for postoperative cholesteatoma. Four studies were additionally included for subgroup analysis of primary cases only. Ranges of sensitivity, specificity, positive predictive value, and negative predictive value yielded

2015 Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

158. The role of tympanostomy tubes in surgery for acquired retraction pocket cholesteatoma. (PubMed)

The role of tympanostomy tubes in surgery for acquired retraction pocket cholesteatoma. 1. To determine whether intraoperative tympanostomy tubes (TT) during surgery for acquired retraction pocket cholesteatoma (ARPC) can decrease recurrence of ARPC and retraction pockets (RP). 2. To determine the need for subsequent TT in children that did not initially receive TT.Retrospective review of children who underwent primary surgery for ARPC.Tertiary care children's hospital.Audiometry, operative (...) subsequently required TT. Audiometric outcomes were not different between groups. TT placement did not significantly affect the odds of recurrent ARPC and RP (95% CI 0.12-1.83, p=0.28 for ARPC and 95% CI 0.30-4.60, p=0.82 for RP). However, the odds of recurrent ARPC and RP were significantly increased in children with stapes and malleus erosion by cholesteatoma. Children with stapes and malleus involvement had 5.28 and 11.8 times higher odds of recurrent ARPC compared to those without ossicular erosion (95

2015 International Journal of Pediatric Otorhinolaryngology

159. Efficacy and Safety of Transcanal Endoscopic Ear Surgery for Congenital Cholesteatomas: A Preliminary Report. (PubMed)

Efficacy and Safety of Transcanal Endoscopic Ear Surgery for Congenital Cholesteatomas: A Preliminary Report. Transcanal endoscopic ear surgery (TEES) can provide greater visual access during resection of middle ear disease than the operating microscope. The purpose of this study was to determine the safety and efficacy of TEES when used for the management of congenital cholesteatoma (CC) in children.Retrospective case review.Tertiary referral center.Twelve children with CC confined (...) to the middle ear underwent TEES. Seven children were Potsic stage I, four were stage II, and one was stage III. The mean follow-up period was 23.1 months.Transcanal middle ear surgery using endoscopes.Incidence of surgical complications and cholesteatoma recurrence.Twelve patients underwent TEES and four patients underwent microscopic surgery during the same period. No surgical complications occurred. Postoperative audiograms were available for 7 of 12 patients who had puretone averages ranging from 3.3

2015 Otology and Neurotology

160. The Efficacy of Color-Mapped Diffusion-Weighted Images Combined With CT in the Diagnosis and Treatment of Cholesteatoma Using Transcanal Endoscopic Ear Surgery. (PubMed)

The Efficacy of Color-Mapped Diffusion-Weighted Images Combined With CT in the Diagnosis and Treatment of Cholesteatoma Using Transcanal Endoscopic Ear Surgery. To assess the efficacy of a color-mapped diffusion-weighted image combined with a computed tomography scan (CMDWI-CT) in preoperatively evaluating the anatomical location of cholesteatomas and determining whether a patient is indicated for transcanal endoscopic ear surgery (TEES) to reduce intraoperative switching to microscopic ear (...) surgery (MES).Prospective case study.A single university hospital.Fifty-five patients scheduled for middle ear cholesteatoma surgery.The CMDWI-CT is produced in a multistep process. A color-mapped fusion image (CMFI) is created by performing MR cisternography on a 1-mm thin-slice nonecho planar diffusion-weighted imaging (non-EPI DWI) and then by performing color mapping on the resulting image to enhance cholesteatoma visualization. False positives are reduced by taking a T1-weighted image (T1WI

2015 Otology and Neurotology

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