Cholesteatoma

A large postauricular cutaneous mastoid fistula caused by a cholesteatoma

March 31, 2010     Raman Wadhera, MS, S.P. Gulati, MS, Vijay Kalra, MS, Anju Ghai, MD, and Ajay Garg, MS
article

Dissection of the incus long process by the chorda tympani nerve

March 31, 2010     Julia Vent, MD, PhD and Dirk Beutner, MD
article

Diffusion-weighted imaging for cholesteatoma evaluation

March 31, 2010     Kara M. Schwartz, MD, John I. Lane, MD, Brian A. Neff, MD, Bradley D. Bolster Jr., PhD, Colin L. Driscoll, MD, and Charles W. Beatty, MD
article

Abstract

Computed tomography (CT) has long been considered the optimal imaging technique for the detection of cholesteatomas. However, this modality often lacks specificity, particularly in patients with an absence of definite bony erosion or a history of surgical excision. Several investigators have proposed magnetic resonance imaging with diffusion-weighted imaging (DWI) as a means of diagnosing the presence and extent of cholesteatomas, particularly when CT results are equivocal. The rationale for the use of DWI is that cholesteatomas demonstrate restricted diffusion and granulation tissue does not. In this retrospective study, we review our experience with 12 patients who had undergone DWI for evaluation of a mass in the middle ear, mastoid, or petrous apex. Ten of these patients had previously undergone middle ear surgery, 8 for cholesteatoma resection. On DWI, 9 patients demonstrated restricted diffusion. Of these, 8 patients underwent surgical resection, and all were found to have had a cholesteatoma. Of the 3 patients who had not demonstrated restricted diffusion on DWI, 2 did not undergo surgery and the other was found to have only chronic inflammation at surgery. Based on our limited experience, we believe that DWI can be useful in confirming the diagnosis of cholesteatoma. Moreover, it may alter patient management, particularly in patients whose previous tympanoplasty/mastoidectomy does not allow for an adequate clinical inspection of the middle ear cavity.

Cholesteatoma

October 31, 2009     Gabriel Caponetti, MD, Lester D. R. Thompson, MD, and Liron Pantanowitz, MD
article

External auditory canal cholesteatoma: A rare complication of tympanoplasty

October 31, 2009     Borlingegowda Viswanatha, MS, DLO
article

Abstract

The author describes a rare case of external auditory canal cholesteatoma. This particular case occurred in a 20-year-old woman who had undergone a tympanoplasty 1 year earlier. Previous tympanoplasty is one of several known predisposing factors for external auditory canal cholesteatoma. The mass was excised, and it was diagnosed on histopathology. The patient recovered uneventfully.

An estimate of the number of mastoidectomy procedures performed annually in the United States

April 30, 2008     Lesley C. French, MD, Mary S. Dietrich, PhD, and Robert F. Labadie, MD, PhD
article

Abstract

We conducted a study to estimate the number of mastoidectomy procedures performed annually in the United States. Our results are based on state-specific healthcare utilization data and Medicare-funded procedural data from 2002. The utilization data were obtained from the State Ambulatory Surgery Database, which is made available through the Healthcare Cost and Utilization Project. Statistical Package for the Social Sciences (SPSS) statistical software was used to quantify the number of mastoidectomy procedures performed during 2002 in Maryland, New Jersey, New York, and Florida. Information was also obtained from the Federated Ambulatory Surgery Association on the number of Medicare-funded mastoidectomy procedures performed in 2002. State and U.S. population statistics were obtained from the U.S. Census Bureau. These data were extrapolated to obtain a nationwide estimate of the number of mastoidectomies performed annually in the U.S. With 99% confidence, we determined that 0.73 to 0.94 mastoidectomy procedures were performed per 10,000 population in Maryland and 2.55 to 2.74/10,000 in New York. Estimates for both New Jersey and Florida fell in between. Medicare patients underwent between 1.68 and 1.79 procedures per 10,000 population. Based on these data, we estimate that between 30,000 and 60,000 mastoidectomies are performed each year in the U.S., although we suspect that our range may be an underestimation of the actual number because of some limitations inherent in the data collection process. Although mastoidectomy is a common outpatient procedure, to the best of our knowledge, no report on the annual frequency of mastoidectomy procedures in the U.S. has ever been published in the English-language literature. We hope that our report will serve to motivate further research into technological and surgical advancements surrounding this procedure.

Fibrous dysplasia of the temporal bone complicated by cholesteatoma and thrombophlebitis of the transverse and sigmoid sinuses: A case report

February 1, 2008     Rodrigo Martinez, MD and Jay B. Farrior, MD
article

Abstract

Fibrous dysplasia is a benign condition that can affect the skull and facial bones and cause a broad spectrum of otolaryngologic conditions. We present the case of a boy with polyostotic fibrous dysplasia with involvement of the temporal bone that was first diagnosed when he was 9 years old. His condition eventually became complicated by cholesteatoma and thrombophlebitis of the left transverse and sigmoid sinuses, and he died of his disease at the age of 19 years. We discuss these and other complications of fibrous dysplasia of the temporal bone and their management.

Congenital middle ear cholesteatoma

October 31, 2007     J. Walter Kutz Jr., MD and Rick A. Friedman, MD
article

Attic cholesteatoma

September 30, 2007     J. Walter Kutz Jr., MD; Derald E. Brackmann, MD
article

A 67-year-old man presented with a long history of hearing loss. He denied otorrhea, otalgia, and a history of ear infections.

Cholesteatoma of the maxillary sinus

May 31, 2007     Borlingegowda Viswanatha, MS, DLO; L. Krishna Nayak, MS; Shamanna Karthik, MS
article
 

Cholesteatoma of the external auditory canal in an immunocompromised patient

September 30, 2006     Arun K. Gadre, MD; Jennifer Davies, MD
article

The mechanical reduction of early acquired cholesteatomas in children: Indications and limitations

April 1, 2006     Eric R. Grimes, MD; Glenn Isaacson, MD, FAAP, FACS
article
Abstract
The standard treatment for acquired cholesteatoma involves surgical removal of the lesion and reconstruction of the tympanic membrane. In some children, these lesions can be treated more conservatively. We conducted a retrospective study of 29 ears in 24 children who had been treated for early acquired cholesteatoma with mechanical reduction and a tympanostomy tube. Outcomes measures included hearing status, the postoperative appearance of the tympanic membrane, and the need for additional surgery. We found that anterior and inferior pars tensa lesions, with or without squamous debris, can be successfully reduced, but that posterosuperior retractions respond less well when the ossicular chain has been eroded. None of the children who responded to mechanical reduction required major reconstructive surgery later. We conclude that mechanical reduction of retraction pocket cholesteatomas with tympanostomy tube placement is sufficient to restore normal hearing and a normal tympanic membrane appearance in selected children with early lesions. We also identified several important prognostic features, including the patient's age, the specific location of the retraction pocket on the tympanic membrane, the extent of the pocket, ossicular chain involvement, and the patient's adenoid status.
PreviousPage
of 3Next