1/22. Fibrous dysplasia of the temporal bone and maxillofacial region associated with cholesteatoma of the middle ear.Fibrous dysplasia of the temporal bone is a rare disease which may lead to progressive stenosis of the external auditory canal and the development of cholesteatoma. We present a case in which minimal symptoms were present despite a massive temporal bone fibrous dysplasia. cholesteatoma resulted most probably secondary to external auditory canal stenosis. Retroauricular fistula developed as a result of destructive effect of cholesteatoma, that influenced previous diagnosis and treatment of this clinically silent disease.- - - - - - - - - - ranking = 1keywords = cholesteatoma (Clic here for more details about this article) |
2/22. External acoustic meatus cholesteatoma.cholesteatoma is a condition usually affecting the middle ear and mastoid, but in certain cases it can be found in the external ear canal. It usually affects elderly people and presents with chronic otorrhoea and dull otalgia. The disease can progress to extensive mastoid destruction. Small lesions can be treated with regular microscopic debridement in out-patients while larger lesions require surgery to eradicate the cholesteatoma sac. We present 2 cases of external ear cholesteatoma to add to the less than 50 cases reported to date.- - - - - - - - - - ranking = 1keywords = cholesteatoma (Clic here for more details about this article) |
3/22. The natural history of congenital cholesteatoma.OBJECTIVES: To describe the natural history of congenital cholesteatoma (CC) and to determine whether such a description provides clues about the origins and end points of these lesions. DESIGN: A retrospective qualitative analysis of intraoperative illustrations of 34 consecutive patients with 35 CCs (1 bilateral). SETTING: Two tertiary care children's hospitals. patients: Thirty-four children with CC, mean age, 5.6 years (range, 2-13 years). RESULTS: Congenital cholesteatoma originates generally, but not universally, in the anterior superior quadrant. The progression of growth is toward the posterior superior quadrant and attic and then into the mastoid. Contact with the ossicular chain generally results in loss of ossicular continuity and in conductive hearing loss. CONCLUSIONS: Congenital cholesteatoma appears to have a predictable trajectory of growth, starting as a small pearl in the middle ear, eventually growing to involve the ossicles and mastoid, and causing varying degrees of destruction and functional impairment. The clinical picture of a young child with otorrhea, conductive hearing loss, tympanic membrane perforation in a nontraditional location, and a mastoid filled with cholesteatoma may represent the end point in the natural history of CC, despite the fact that this type of lesion is outside the accepted definition of CC.- - - - - - - - - - ranking = 1.3333333333333keywords = cholesteatoma (Clic here for more details about this article) |
4/22. Supralabyrinthine approach to petrosal cholesteatoma.Petrosal cholesteatomas are rare lesions, which may be congenital or acquired in nature. We report an exceptional case occurring in a seven-year old girl who presented with a unilateral conductive hearing loss, despite normal tympanic membrane appearance. early diagnosis was facilitated by computed tomography (CT) scanning. Although this case satisfied the criteria for congenital cholesteatoma, it is likely that the petrous apex was secondarily involved. Complete cholesteatoma removal was accomplished using a transtemporal supralabyrinthine approach, which allowed for hearing preservation, while avoiding the morbidity associated with a craniotomy. The present case constitutes the youngest case of petrosal cholesteatoma reported. We suggest that a lower threshold for the use of CT scanning in unilateral conductive hearing loss may allow for the earlier detection of more cases of petrosal cholesteatomas, as well as facilitating their removal using more limited approaches associated with less morbidity.- - - - - - - - - - ranking = 1.5keywords = cholesteatoma (Clic here for more details about this article) |
5/22. Labyrinthine anomalies with normal cochlear function.Three cases of labyrinthine anomaly confirmed by polytomography and CT scan are reported. They showed similar dysplasia of the bony labyrinth: dilation and fusion of the lateral semicircular canal (SCC) and of the vestibule with a normally shaped cochlea and other SCCs. One side was involved in 2 cases and both sides in 1 case. The 1st case showed normal hearing levels with markedly reduced response to caloric stimulation in the affected ear. The 2nd case showed conductive hearing loss due to cholesteatoma with normal bone conduction hearing levels and normal caloric response. The 3rd case showed bilateral conductive hearing loss of unknown cause. The classification of labyrinthine anomalies and labyrinthine functions is discussed. Labyrinthine anomaly detected by CT scan and polytomography can be present in patients with normal cochlear and/or vestibular function.- - - - - - - - - - ranking = 0.16666666666667keywords = cholesteatoma (Clic here for more details about this article) |
6/22. Otological manifestations of thalassaemia intermedia: evidence of temporal bone involvement and report of a unique cholesteatoma-like lesion.Thalassaemia intermedia should be considered in any chronically anaemic patient presenting from the middle east with hearing impairment. We report here three Saudi siblings with thalassaemia intermedia and features of severe bone marrow expansion, particularly invading the temporal bone. They were seen first for their otological problems before they had access to proper haematological evaluation. One member was admitted for surgical exploration of a cholesteatoma, which was then found to be marrow expansion of the temporal bone. Screening of the family revealed two more anaemic siblings with thalassaemia intermedia. Audiological examination of all the family members showed that only the two affected members had a high frequency sensori-neural hearing loss. bone marrow expansion into the temporal bone is a rare feature of thalassaemia intermedia. cholesteatoma-like lesion has not been previously described. It has to be considered in all cases of symptomatic thalassaemia intermedia manifesting with cavitation and lytic lesions in the mastoid system. The likelihood that sensorineural hearing loss may complicate the thalassaemias is raised and the possible mechanism for such involvement discussed. The proper management for different otological manifestations of the thalassaemias is suggested. These cases would suggest a more extensive involvement of the temporal bone in the thalassaemias than has been previously recognized. Further large scale studies are required to illuminate the subject.- - - - - - - - - - ranking = 0.83333333333333keywords = cholesteatoma (Clic here for more details about this article) |
7/22. Radiological case of the month. Monostotic fibrous dysplasia of the temporal bone.Computed tomographic scan demonstrating narrowing of the left external auditory canal caused by an expansile bone lesion of the temporal bone (curved arrow). The regional bone was characterized by a "ground-glass" appearance. A small cholesteatoma is located between the tympanic membrane and the bony lesion (black arrow).- - - - - - - - - - ranking = 0.16666666666667keywords = cholesteatoma (Clic here for more details about this article) |
8/22. Fibrous dysplasia of the temporal bone.A 38-year-old woman with fibrous dysplasia of the entire right half of the mandible and the right temporal bone is presented. She had a unilateral progressive conductive hearing loss and stenosis of the auditory canal complicated by a chronic external otitis, a hidden cholesteatoma, destruction of the ossicles and an impending facial palsy. Surgery was performed to create a new auditory canal, to eradicate the cholesteatoma and to decompress the facial nerve from the surrounding fibrous dysplasia.- - - - - - - - - - ranking = 0.33333333333333keywords = cholesteatoma (Clic here for more details about this article) |
9/22. Double intratemporal congenital cholesteatomas combined with ossicular anomalies.A 15-year-old patient had unilateral double congenital cholesteatomas, one isolated to the mastoid and the other located in the petrous pyramid. The presenting symptoms were facial palsy and a conductive hearing loss on the affected side. The case is interesting, not only in that there were two isolated cholesteatomas in the same temporal bone, but also because of the combination of ossicular anomalies. The unusually early detection and surgical intervention in this instance suggest that similar cases of multicentric cholesteatomas may have occurred, but may have been concealed because of the later detection and possible linkage of the cholesteatomas. I would therefore emphasize Sheehy's recommendation that temporal bone radiography never be omitted where idiopathic facial nerve palsy exists.- - - - - - - - - - ranking = 1.3333333333333keywords = cholesteatoma (Clic here for more details about this article) |
10/22. Middle ear surgery in fibrous dysplasia of the temporal bone.Fibrous dysplasia of the temporal bone is uncommon. When it does occur, surgery may be necessary because of cholesteatoma or chronic infection behind bony obstruction of the external auditory canal. Cosmetic surgery may also be performed because of bony deformity. When a surgical procedure is undertaken for hearing improvement, special problems may be encountered. The case presented illustrates middle ear pathologic changes found with fibrous dysplasia and specific surgical difficulties.- - - - - - - - - - ranking = 0.16666666666667keywords = cholesteatoma (Clic here for more details about this article) |
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