1/10. A case of giant cholesteatoma extending to the posterior fossa.We present a 43-year-old male patient who developed a giant cholesteatoma with lateral sinus obliteration and involvement of the posterior cranial fossa. The only complaints were left-sided aural discharges and total sensorineural hearing loss. Examination revealed a mass lesion consistent with cholesteatoma within the left middle ear. Computed tomography and magnetic resonance imaging showed an extensive acquired cholesteatoma in the left middle ear, invading the posterior cranial fossa and leading to lateral sinus obliteration. The patient underwent left radical mastoidectomy. He had an uneventful postoperative follow-up for 13 months. This case emphasizes the value of preoperative radiologic assessment of giant cholesteatomas that may present with relatively few or limited symptoms.- - - - - - - - - - ranking = 1keywords = cholesteatoma (Clic here for more details about this article) |
2/10. Pediatric external canal cholesteatoma with extensive invasion into the mastoid cavity.cholesteatoma in the external auditory canal (EAC) is an uncommon situation, and is especially rare in pediatric patients. We report two pediatric cases of external canal cholesteatoma with extensive invasion into mastoid cavity. Both cases had otalgia and poor hearing as the initial symptoms, and received operation according to the extent of the lesions. Since external canal cholesteatoma with extensive invasion into the mastoid cavity has the propensity to involve the vertical segment of the facial nerve, extreme care should be taken when performing any procedure in this area. Through thorough pre-operative evaluation and adequate surgical procedures, good outcomes can be achieved and hearing as well as facial nerve function can be preserved.- - - - - - - - - - ranking = 0.75keywords = cholesteatoma (Clic here for more details about this article) |
3/10. fistula of the cochlear labyrinth in noncholesteatomatous chronic otitis media.OBJECTIVE: To discuss the clinical aspects and management of promontory fistula of the cochlear labyrinth. STUDY DESIGN: Case report and review of the literature. SETTING: University hospital, tertiary referral center. PATIENT, INTERVENTION, AND RESULTS: The authors describe an unusual case of cochlear fistula localized to the promontory discovered during tympanoplasty for noncholesteatomatous chronic otitis media in a 59-year-old woman. bone conduction was slightly impaired after operation and hearing improved after a revision myringoplasty performed for reperforation. CONCLUSION: Erosion of the bone of the labyrinth can also be observed in noncholesteatomatous otitis media. The presence of a fistula is not always associated with profound hearing loss. Overlying pathologic tissue can be removed without damaging the membranous labyrinth.- - - - - - - - - - ranking = 0.75keywords = cholesteatoma (Clic here for more details about this article) |
4/10. Reconstruction of the tensor tympani tendon.We describe a case in which reconstruction of the tendon of the tensor tympani muscle was necessary for the successful restoration of sound conduction. The right ear of a nine-year-old boy was treated for cholesteatoma with staged surgery. During the first operation, the tendon was cut to ensure good visibility in the tympanic cavity. Post-operatively, maintenance of aeration of the middle ear required ventilation tubes at first and Valsalva manoeuvres later on. The position of the reconstructed tympanic membrane varied a great deal, moving between the medial wall of the tympanic cavity and extreme bulging. This made exact measurement of a columella for ossicular reconstruction impossible. The preserved handle of the malleus was bound to the cochleariform process with ionomer cement, using a piece of surgical suture material as a substitute for the tendon. This arrangement prevented the tympanic membrane from undergoing excessive lateral movement after inflation and the ossicular chain was replaced with a successful ossiculoplasty with an autogenous bone 'drum to footplate' columella. The pre-operative 55.0 dB air-bone gap decreased immediately to 3.3 dB, widening after three years to 15.0 dB.- - - - - - - - - - ranking = 0.125keywords = cholesteatoma (Clic here for more details about this article) |
5/10. diagnosis and management of aggressive, acquired cholesteatoma with skull base and calvarial involvement: a report of 3 cases.A prospective case review of 3 patients treated at a tertiary referral center from 1997 to 2002 are presented. Three men, age 30 to 68 (mean, 45) years, were treated for acquired cholesteatoma with skull base invasion. Two patients had no prior otological surgery, and 1 was detected after 4 prior mastoid procedures. One presented with progressive unilateral facial palsy, 1 with otorrhea, and 1 with temporal mass above a modified radical mastoidectomy cavity. All 3 patients were treated with single-staged canal wall-down mastoidectomy. patients were followed up with otoscopy and neuroimaging from 40 to 61 months. Two patients had no recurrence of cholesteatoma, and 1 had squamous debris in the mastoid cavity removed in the outpatient clinic. One had complete ipsilateral facial nerve paralysis preoperatively and recovered to House-Brackmann grade III within 1 year of surgery. Patient 1 had labyrinthine involvement before surgery and had ipsilateral anacusis after resection and repair. No other complications occurred. Initial presentation, workup, surgical challenges, disease follow-up, facial nerve function, hearing results, and complications are reported.- - - - - - - - - - ranking = 0.75keywords = cholesteatoma (Clic here for more details about this article) |
6/10. Two cases of cholesteatoma behind intact tympanic membrane with embryogenetic anomalies.Two new interesting cases of cholesteatoma of the middle ear behind an intact tympanic membrane are presented in this report. In both cases, which would fulfill Derlacki's criteria for a congenital cholesteatoma, the presence of an embryogenetic anomaly in the affected ear was noted. This association is suggestive of the congenital hypothesis of the observed cases.- - - - - - - - - - ranking = 0.75keywords = cholesteatoma (Clic here for more details about this article) |
7/10. 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 = 1keywords = cholesteatoma (Clic here for more details about this article) |
8/10. Labyrinthine ossification: etiologies and CT findings.Ossification of the membranous labyrinth (labyrinthitis ossificans) develops as the final result of many inflammatory processes, for example, meningitis, blood-borne septic emboli, middle ear infection, and cholesteatoma. Labyrinthine ossification may also occur as a result of previous labyrinthectomy or secondary to trauma. Seven cases of labyrinthine ossification accompanied by severe vertigo and total hearing loss in the affected ear are discussed. The computed tomographic appearance of varying degrees of ossification, the clinical and surgical circumstances from which this disorder may develop, and the various approaches to labyrinthectomy are described.- - - - - - - - - - ranking = 0.125keywords = cholesteatoma (Clic here for more details about this article) |
9/10. otosclerosis in a black child: diagnostic acoustic impedance studies.otosclerosis classically describes an osteodystrophic change in the bony labyrinth and stapes footplate, of autosomal dominant inheritance, reported rare under the age of 5, extremely "rare" in the Oriental and Black race, "non-existent" in the American Indian, and with a clinical incidence of 5 per 1000 Caucasians. The differential diagnosis of a non-effusion conductive hearing loss in a child should include otosclerosis, congenital malleus or footplate fixation, tympanosclerotic fixation, congenital cholesteatoma, lysis of the incus long process, Paget's disease, osteogenesis imperfecta, and fibromuscular hyperplasia of the renal artery. Presented is a case report of a 14-year-old black male with bilateral clinical otosclerosis and a persistent stapedial artery. Preoperative multiple-frequency tympanometry and Zwislocki acoustic reactance and resistance analysis demonstrated absence of the "W" resonance pattern on high-frequency tympanometry and the classic friction and stiffness patterns of otosclerotic fixation. Repeat multiple-frequency tympanometry testing post-stapedectomy demonstrated prosthesis articulation. Prosthesis position can be monitored postoperatively by these acoustic impedance studies.- - - - - - - - - - ranking = 0.125keywords = cholesteatoma (Clic here for more details about this article) |
10/10. Congenital cholesteatoma of the petrous pyramid.A congenital cholesteatoma arising from the petrous pyramid is rarely encountered, and we report a case of such a cholesteatoma in a 23-year-old male. This cholesteatoma was successfully removed by a middle cranial fossa approach. The cholesteatoma showed a unique mode of spread, that is, it originated from the pyramidal apex and extended in two directions: through the facial canal to the tympanic sinus, and along the tympanic tegmen to the mastoid antrum. We discuss the importance of CT and MRI for achieving a diagnosis, as well as the merits of using a middle cranial fossa approach for the surgical excision of this cholesteatoma.- - - - - - - - - - ranking = 1.125keywords = cholesteatoma (Clic here for more details about this article) |
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