Facial nerve paralysis: Smile reconstruction using the masseteric nerve

September 20, 2015     Moustafa Mourad, MD; Christopher Linstrom, MD; Grigoriy Mashkevich, MD

Reanimation methods range from static slings and nerve transfers to dynamic muscle techniques, such as regional temporalis and free gracilis transfer.

Intratympanic membrane congenital cholesteatoma

July 20, 2015     Hiroshi Sakaida, MD, PhD; Kazuhiko Takeuchi, MD, PhD

Cholesteatoma should be differentiated from other conditions with similar otoscopic findings, such as myringosclerosis.

Is there a relationship between myeloperoxidase activity and conductive hearing loss in chronic otitis media complicated by cholesteatoma?

April 27, 2015     Ozlem Celebi Erdivanli, MD; Arif Sanli, MD


We conducted a prospective, controlled study of patients with chronic otitis media and cholesteatoma (1) to examine the expression of myeloperoxidase (MPO) using immunohistochemical staining techniques and (2) to investigate the relationship between MPO activity and the degree of conductive hearing loss in these patients. Our study population included 51 adults-26 men and 25 women, aged 18 to 58 years (mean: 37.5)-who had been diagnosed with chronic otitis media and cholesteatoma by physical examination and computed tomography (study group). Another 30 patients-13 men and 17 women, aged 18 to 52 years (mean: 32.7)-who had chronic otitis media without cholesteatoma served as the control group. Following audiometric evaluations, all patients underwent appropriate surgery. Postoperatively, cholesteatoma samples were analyzed by immunostaining for MPO positivity as a marker for acute inflammation. We found that MPO activity was present in all 51 study patients (100%) but in only 10 controls (33.3%); the difference was statistically significant (p< 0.01). In the study group, the degree of MPO activity was slight in 6 patients (11.8%), moderate in 24 patients (47.1%), and intense in 21 patients (41.2%), while in the control group, all 10 MPO-positive cases showed only a slight degree of activity. We also found a statistically significant association in the study group between the degree of MPO activity and the degree of conductive hearing loss (χ2 = 13.518; p < 0.001). We encourage further study of all steps in the process of cholesteatoma formation.

Unexpected cholesteatoma in a very young child with a congenital aural duplication anomaly

April 27, 2015     Moo Kyun Park, MD

Cholesteatoma can develop in very young children with congenital aural stenosis and a duplication anomaly, and physicians should consider this condition in affected children with otalgia and otorrhea.

Vestibular dehiscence syndrome caused by a labyrinthine congenital cholesteatoma

February 2, 2015     Francesco Fiorino, MD; Francesca B. Pizzini, MD, PhD; Barbara Mattellini, MD; Franco Barbieri, MD


A 40-year-old man presented with conductive hearing loss and pressure- and sound-related vestibular symptoms. Computed tomography and diffusion-weighted magnetic resonance imaging revealed the presence of a cholesteatoma involving the vestibular labyrinth. The patient underwent a canal-wall-up tympanoplasty, which revealed evidence of a disruption of the vestibular labyrinth and a wide dehiscence of the vestibule, which was immediately resurfaced. At the 2-month follow-up, the patient's pressure- and sound-related vestibular symptoms had disappeared. Pure-tone audiometry showed a reduction in the air-bone gap with a slight deterioration of bone conduction and an improvement in the air-conduction threshold. Fistulization of the otic capsule produces a “third window,” which can lead to a dehiscence syndrome. One possible cause is a cholesteatoma of the middle ear or petrous bone. When the vestibule is invaded by a cholesteatoma, hearing is almost invariably lost, either pre- or postoperatively. However, in our case, wide opening of the vestibule resulted in hearing preservation.

Bilateral external auditory canal cholesteatomas

March 18, 2014     Danielle M. Blake, BA; Alejandro Vazquez, MD; Robert W. Jyung, MD

External auditory canal cholesteatomas may be classified as idiopathic or secondarily acquired, most commonly occurring in postoperative or post-traumatic settings.

Acquired cholesteatoma presenting as a pars squamosa temporal bone mass

February 12, 2014     Christopher Vanison, MD; Eric M. Jaryszak, MD, PhD; Amanda L. Yaun, MD; and Diego A. Preciado, MD, PhD


Acquired cholesteatomas typically arise in the middle ear and mastoid cavities; they rarely present elsewhere. We describe a case of acquired cholesteatoma that presented as a large mass of the pars squamosa of the temporal bone in a 16-year-old girl. The mass was surgically removed without complication. To the best of our knowledge, this is only the second reported case of an acquired cholesteatoma in the lateral temporal bone.

Congenital cholesteatoma in a 3-year-old

April 17, 2013     Danielle M. Blake, BA; Senja Tomovic, MD; Robert W. Jyung, MD

 When a congenital cholesteatoma is diagnosed early as a localized circumscribed mass, it can be resected with a very low risk of recurrence.

External auditory canal cholesteatoma

July 5, 2012     Joseph A. Ursick, MD; Derald E. Brackmann, MD

External auditory canal cholesteatomas, which result from the deposition of squamous epithelium deep to the skin of the external canal, can be caused by postsurgical implantation, radiation, or trauma.

Cholesteatoma of the nose and maxillary and ethmoid sinuses: A rare complication of palatal surgery

September 20, 2011     Borlingegowda Viswanatha, MS, DLO


A 10-year-old boy presented with a complaint of a left-sided nasal obstruction with an associated foul-smelling discharge. Physical examination and anterior rhinoscopy revealed that a whitish, friable mass had completely filled the left nasal cavity. On computed tomography, a soft-tissue mass was seen filling the cavity and extending to the paranasal sinuses with bone erosion. A biopsy of the mass suggested that it represented a cholesteatoma. The lesion was removed via nasal endoscopy, and histopathology confirmed the diagnosis of a cholesteatoma. No recurrence was noted during 6 months of follow-up. Cholesteatoma of the paranasal sinuses is a rare entity, as only a few dozen cases have been reported in the literature.

Spontaneous posterior wall external canal cholesteatoma

July 13, 2011     Luca Oscar Redaelli de Zinis, MD

Congenital middle ear cholesteatoma

October 31, 2010     Min-Tsan Shu, MD, Hung-Ching Lin, MD, Cheng-Chien Yang, MD, and Yu-Chun Chen, MD
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