1/5. External canal cholesteatoma.OBJECTIVE: External canal cholesteatoma (ECC) may develop spontaneously or as a consequence of infection, trauma, or surgery. There is little information on the relative incidence of ECC according to cause. An analysis of cases was conducted to compare the clinical, surgical, and radiographic features of different types of ECC. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. patients: All patients with cholesteatoma of the external auditory canal. INTERVENTION: Treatment was variable, ranging from local debridement and topical antibiotics to tympanomastoidectomy. MAIN OUTCOME MEASURE: Assignment of cause is based on the combination of clinical history, physical examination, and radiographic appearance. RESULTS: A total of 39 patients were reviewed, 5 of them with bilateral lesions. The cause was iatrogenic in 15, spontaneous in 13, trauma in 6, congenital in 2, postinflammatory in 2, and postobstructive in 1. Surgery was performed in 25 cases. Successful results were obtained in most patients. CONCLUSION: The cause of an ECC is determined on the basis of clinical features and radiographic appearance. The treatment plan is influenced by the cause of the ECC. Surgery is frequently necessary in congenital, posttraumatic, postobstructive, and iatrogenic ECC. Spontaneous lesions are usually controlled with office debridement.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/5. 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.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/5. facial nerve and medially invasive petrous bone cholesteatomas.Eight patients with extensive petrous bone cholesteatomas that invaded the labyrinth and fallopian canal are presented. The eight cases are added to a tabulation of prior literature reports to elucidate concepts of routes of extension of medially invasive temporal bone cholesteatoma. Medially invasive petrous bone cholesteatoma develops insidiously, often without symptoms other than facial palsy and/or unilateral deafness. Typically, a history of chronic ear disease can be obtained. While hearing is unlikely to be preserved in this group of patients, facial nerve function can usually be preserved, and a facial nerve graft was not necessary in our series. Acute facial nerve palsy or facial nerve paresis progressing to palsy in patients with a history of chronic ear disease should be studied radiographically for petrous bone cholesteatoma, even if there is no physical evidence of cholesteatoma.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/5. cholesteatoma of the external auditory canal and keratosis obturans.keratosis obturans and external auditory canal cholesteatoma have often been regarded as a single entity. However, these are two distinct disorders with their own clinical presentations, physical and pathologic findings, and treatment. keratosis obturans is an accumulation of obstructive desquamated keratin in the external auditory meatus. External auditory canal cholesteatoma is an invasion and erosion of squamous epithelium into a localized area of the bony ear canal. The origin of both entities remains obscure. The clinical symptoms, pathologic processes, and treatment are outlined and compared. case reports are presented to illustrate the features of these two diseases.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/5. Bilateral congenital cholesteatomas.Congenital cholesteatoma is a rare entity. Bilateral involvement is rarer still. We present the sixth case of bilateral congenital cholesteatoma and briefly review the theories regarding the origin of congenital cholesteatoma. The lesion in the left ear was seen on physical examination, however the lesion in the right ear was detected only on a computed tomography (CT) scan, which was obtained to assess the extent of the disease on the left side. Although usually asymptomatic, these cholesteatomas can enlarge and lead to complications. Management of congenital cholesteatoma by various surgical approaches is discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |