Cases reported "Cholesteatoma"

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1/66. External cholesteaoma and fibrous dysplasia of temporal bone.

    cholesteatoma is a disease that involves almost exclusively the middle ear structures and the mastoid bone. In rare cases it involves the external auditory canal. The author would like to present case report of a patient affected by external ear canal cholesteatoma associated to fibrous dysplasia of the temporal bone. The problems related to the pathogenesis and the diagnosis of the disease are presented and discussed.
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2/66. Acute mastoiditis and cholesteatoma.

    Acute coalescent mastoiditis is an uncommon sequela of acute otitis media. It occurs principally in the well-pneumatized temporal bone. The findings of fever, pain, postauricular swelling, and otorrhea are classic. cholesteatoma, on the other hand, being associated with chronic infection, usually occurs in the sclerotic temporal bone. The signs and symptoms are isidious in nature and consist of chronic discharge and hearing loss which result from its mass, bone erosion, and secondary infection. Of 17 consecutive cases of acute mastoiditis over a six-year period, four were atypical because they were complications of chronic otitis media and cholesteatoma, yet they had the physical findings of acute mastoiditis-subperiosteal abscess and purulent otorrhea, plus radiographic evidence of mastoid coalescence.
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3/66. Congenital cholesteatoma of external auditory canal.

    A 7-month-old male child is reported with congenital cholesteatoma of the external auditory canal. We describe the clinical features, computed tomography finding and surgical treatment. Congenital cholesteatomas can occur within the temporal bone. There are six places of location: (1) petrous apex, (2) mastoid, (3) middle ear, (4) both middle ear and mastoid, (5) external ear canal and (6) within the squamous portion of the temporal bone. Congenital cholesteatoma of the external auditory canal is rare. Generally, it appears in the canal floor without lesions in the tympanic membrane. Computed tomography completes the study. Treatment consists of excision of the mass.
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4/66. Spontaneous external auditory canal cholesteatoma complicated by rheumatoid arthritis--case report and review of the literature.

    A 63-year-old woman with rheumatoid arthritis sought medical assistance for dull and chronic pain in her left ear two and half years after her initial diagnostic examination. Otoscopic examination revealed that the posteroinferior wall of the bony external ear canal was eroded and that the small cavity was filled with squamous debris. The condition was diagnosed as external auditory canal cholesteatoma (EACC). The existence of EACC might suggest complications of bone disease, aging cerumen gland, or a low migratory rate of the epithelium.
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5/66. Epidermoids involving the temporal bone: clinical, radiological and pathological aspects.

    Epidermoids or congenital cholesteatomas arise from aberrant epithelial remnants and are, therefore, considerd blastomatous malformations. Their predilective sites are the intracranial cavity, the diploe of the skull and the spinal canal. In the base of the skull the temporal bone is the most frequent site. Epidermoids account for about 0.2-1.5 percent of all intracranial tumors. The majority originate in the cerebello-pontine angle where they account for 6-7 percent of all tumors. Their age incidence reveals a great scatter from birth to 80 years. The majority are recognized during the third and fourth decades with the onset of clinical symptoms occurring much earlier. They affect males more frequently than females. Their delicate capsule with a whitish mother-of-pearl sheen lends them a typical appearance. Epidermoids are generally slow growing lesions which may remain asymptomatic for years. The irritative effect of their content, however, can produce symptoms of dysfunction and intense inflammation. Malignant changes occur infrequently. Diploic epidermoids are easily recognized, whereas, intradural epidermoids are more difficult to identify. Epidermoids may arise in the vicinity, on the outer aspect or within the temporal bone. Epidermoids originating in any of these locations have certain characteristic features which may arouse suspicion of their presence. Examples of an epidermoid with origin in the typical locations within the temporal bone and cerebello-pontine angle are discussed to portray their individual characteristics.
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6/66. 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 implantation cholesteatomas.
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7/66. Bone destruction resulting from rupture of a cholesteatoma sac: temporal bone pathology.

    OBJECTIVE: The purpose of the current study was to research the pathogenesis of bony destruction of cholesteatoma. STUDY DESIGN: We conducted a case report. SETTING: The study was performed at Fukushima Medical University. patients: The first case involved a 21 trisomy, whereas the second case was cancer of the hypopharynx. Both cases showed cholesteatoma. RESULTS: The following histopathologic findings in the temporal bones of cholesteatoma were obtained. Bony destruction in cholesteatoma was detected in the lesion of the rupture of the cholesteatoma sac. Epithelial debris of cholesteatoma was scattered throughout the rupture of the cholesteatoma sac. rupture of the matrix was the result of a small abscess. CONCLUSION: rupture of the cholesteatoma sac was believed to have been a pathway of either endogenous substances from the matrix and/or epithelial debris of cholesteatoma.
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8/66. Parotid masses in patients with previous ear surgery.

    This paper describes three cases of patients presenting with lumps in their parotid gland, the origin of which was difficult to define. In each case the past medical history revealed that the patients had undergone previous ipsilateral middle ear surgery. We highlight the fact that where there has been previous incisions in the skin about the ear, there is a risk of epidermal inclusion cysts in the parotid gland. These cysts can occur many years after the initial surgery and therefore may not be identified as an obvious origin to lumps in the parotid gland. Rarely as this series highlights there may also be extension of a cholesteatoma (a collection of keratin which arises from the eardrum and extends into the middle ear space) from the mastoid bone to the parotid gland. We recommend formal ear examination where there is a history of previous ear surgery and an ipsilateral parotid gland lump is present.
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9/66. 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.
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10/66. Clinical controversy in orbitary cholesteatoma.

    cholesterol granulomas are tumor-like lesions very rarely encountered in the orbital, frontal sinus, and maxillary sinus sites but with higher frequency in the middle-ear and petrous apex. Theoretically, cholesterol granulomas develop as a reaction to localized hemorrhages, often occurring in bony sites with no blood and blood products drainage. We present 5 cases with exophthalmoses, namely, 3 cases with granuloma and 2 cases with cholesteatoma, all being characterized by the presence of cholesterol spikes at the histologic examination. Henderson (Orbital tumors. 3rd ed. new york: Raven Press; 1994) reports cholesterol spikes in medical literature as structures with different histologic names as hematic cyst, intraorbital hematoma, subperiostal hemorrhages, chocolate cyst, and xanthomatosis reactive lesions of bone. In fact, cholesterol granuloma is the term for the pocket of hematogenous debris found in the frontal bone at surgery. We try to review the spectrum of clinical-pathological and radiographic features that characterize cholesterol granuloma but with the same surgical way management.
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