Cases reported "Cholesteatoma, Middle Ear"

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1/85. 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. ( info)

2/85. tympanoplasty in a patient with hemophilia b.

    We report the case of a 36-year-old hemophilia b who suffered from cholesteatoma and underwent tympanoplasty. Though the factor ix activity was less than 1% of normal before surgery, adequate replacement of factor ix led to the achievement of hemostasis during and after surgery. The cholesteatoma was completely extirpated with matrix, and a type I canal-up tympanoplasty was subsequently performed. Careful preoperative evaluation and close cooperation with the hematologist are required if surgery is to be successful. We also present here the use of continuous administration of monoclonal antibody-purified factor ix concentrate, Christmassin M. ( info)

3/85. cholesteatoma extending into the internal auditory meatus.

    We report our experiences in managing a patient with cholesteatoma complicated by meningitis, labyrinthitis and facial nerve palsy. The antero-inferior half of the tympanum was aerated but the postero-superior portion of the tympanic membrane was tightly adherent to the promontry mucosa. An attic perforation was present at the back of the malleolar head. High-resolution computed tomography also uncovered a fistula in the lateral semicircular canal. Surgical exploration of the middle ear cavity demonstrated that both the vestibule and cochlea were filled with cholesteatoma, and the cholesteatoma extended into the internal auditory meatus through the lateral semi-circular canal fistula. The cholesteatoma was removed by opening the vestibule and cochlea with a preservation of the facial nerve. Post-operatively, an incomplete facial palsy remained, but has improved slowly. There is no sign of recurrence to date after a 3-year period of observation. ( info)

4/85. Unusual cases of congenital cholesteatoma of the ear.

    Congenital cholesteatoma may originate at various sites in the temporal bone. For example, in the petrous apex, the cerebellopontine angle, the middle ear cavity, the mastoid process or the external auditory canal. The least common site being the mastoid process. We present two cases of congenital cholesteatoma of the mastoid process, each presenting with different symptoms and at different ages. Both patients underwent surgical treatment, which confirmed the diagnosis and radiological findings. ( info)

5/85. Factors affecting recovery of mastoid aeration after ear surgery.

    Fifty-six patients after tympanomastoid surgery were examined to determine recovery of mastoid aeration and various pre- and intraoperative factors such as eustachian tube (ET) function, how the mastoid mucosa had been treated during surgery and whether or not a large silastic sheet had been placed in the middle ear or a ventilation tube used. mastoid aeration recovery was confirmed by computed tomography in 27 of the 57 cases (47%) within 12 months of surgery. Among the factors examined, preservation of the epitympanic mucosa was found to be most important in mastoid aeration recovery. Use of a large silastic sheet to cover the area from the bony ET and tympanic cavity to epitympanum, aditus ad antrum or antrum was found to be of some help in recovery mastoid aeration after complete resection of the mucosa and mastoid air cells. Preoperative ET function, anterior tympanotomy and use of a ventilation tube did not influence recovery. ( info)

6/85. cholesteatoma in a child with congenital ichthyosiform erythroderma.

    A 7-year-old girl had non-bullous congenital ichthyosiform erythroderma (NBCIE) in treatment with retinoids. She also suffered continuous desquamation of the external ears, recurrent external otitis, chronic adenoiditis, tubaric dysfunction and intermittent episodes of otitis media and developed a cholesteatoma in her left ear. Chronic scaling disorders, such as NBCIE and other ichthyosis, can be entities at risk for the development of cholesteatoma in childhood. ( info)

7/85. Can MRI replace a second look operation in cholesteatoma surgery?

    The purpose of this paper is to investigate whether a magnetic resonance imaging (MRI) examination of the petrous bones could replace the conventional second look surgical procedure when a canal wall up tympanoplasty procedure has been performed during the first look surgery. Eighteen patients were examined with MRI prior to a second look surgical procedure. MRI was performed on a 1.5 T superconducting system. T2 weighted images before contrast and T1 weighted images after contrast (gadopentate dimeglumine) were obtained. Imaging results were compared with surgical findings. The poor radiosurgical correlation (50% and 61% after re-evaluation) suggests that, at the present time, MRI is not a valid alternative to a second look surgical intervention in the case of cholesteatoma treated by canal wall up tympanoplasty. In our study, MRI was not capable of differentiating small pearls of residual cholesteatoma from surrounding scar tissue. ( info)

8/85. Primary basal cell carcinoma of the middle ear presenting as recurrent cholesteatoma.

    OBJECTIVE: This study aimed to sensitize the practitioner to the unusual presentation of basal cell carcinoma in a recurrent cholesteatoma mass. STUDY DESIGN: The study design was a case report format. SETTING: The study was conducted at a tertiary referral hospital. PATIENT: The patient studied was a contralaterally anacusic veteran. INTERVENTION: Interventions were excision of cholesteatoma and withholding of adjunctive radiation. CONCLUSION: Primary basal cell carcinoma may present in a revision cholesteatoma field. ( info)

9/85. Intratympanic cholesteatoma.

    Cholesteatomas occurring behind an intact TM are relatively unusual, and intratympanic keratomas are even less common. This article presents the case of a Baffin Zone Inuit gentleman with an intratympanic cholesteatoma confined to the membranous portion of his TM. Although it is generally accepted that many native populations, including the Inuit, demonstrate an elevated preponderance of aural disease, cholesteatoma formation, particularly within the TM, in an individual from this area of the high Arctic is extremely rare. ( info)

10/85. Soft-wall reconstruction for cholesteatoma surgery: reappraisal.

    OBJECTIVE: To reevaluate the validity of the soft-wall reconstruction method of the posterior meatal wall in surgeries for cholesteatomas. STUDY DESIGN: Retrospective case review. patients: Subjects consisted of 52 patients (54 ears) with fresh cholesteatoma (excluding residual or recurrent cholesteatomas) who were operated by the soft-wall reconstruction method in our clinic and observed for more than 2 years after surgery, and 29 patients (29 ears) who were operated by canal-wall-down and open method. MAIN OUTCOME MEASURES: postoperative period required for complete epithelization (dry ear), hearing, and incidence of the residual and recurrent cholesteatomas were compared with those operated by canal-wall-down and open method. The postoperative conditions of the soft posterior meatal wall was also investigated. RESULTS: postoperative period to be a dry ear was significantly shorter in the soft-wall reconstruction group than in the canal-wall-down and open group (Student's t-test, t = 2.99, p < 0.01). There was no significant difference in the postoperative hearing or incidence of residual and recurrent cholesteatomas between the two groups. CONCLUSIONS: These results indicate that the soft-wall reconstruction method seems more versatile than the canal-wall-down and open method for cholesteatoma surgery. ( info)
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