Deceptive Facial Nerve Variant May Cloud Otologists’ Judgment: A Dilemma in Middle Ear Surgery

Kuo, Chin Lung; Liao, Wen-Huei; Li, Wing Yin; Lirng, Jiing Feng; Lien, Chiang Feng

doi:10.5152/iao.2014.333

Cited by 3 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, surgeons have personal beliefs regarding specific techniques which are largely based on their own area of expertise. Practitioners should endeavor to be flexible when choosing surgical approaches [ 171 ]. Nonetheless, to a certain extent, the outcome of surgery is determined by the proficiency of the surgeon, regardless of surgical technique he or she chooses.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Updates and Knowledge Gaps in Cholesteatoma Research

Kuo

Shiao

Yung

et al. 2015

BioMed Research International

Self Cite

176

179

View full text Add to dashboard Cite

The existence of acquired cholesteatoma has been recognized for more than three centuries; however, the nature of the disorder has yet to be determined. Without timely detection and intervention, cholesteatomas can become dangerously large and invade intratemporal structures, resulting in numerous intra- and extracranial complications. Due to its aggressive growth, invasive nature, and the potentially fatal consequences of intracranial complications, acquired cholesteatoma remains a cause of morbidity and death for those who lack access to advanced medical care. Currently, no viable nonsurgical therapies are available. Developing an effective management strategy for this disorder will require a comprehensive understanding of past progress and recent advances. This paper presents a brief review of background issues related to acquired middle ear cholesteatoma and deals with practical considerations regarding the history and etymology of the disorder. We also consider issues related to the classification, epidemiology, histopathology, clinical presentation, and complications of acquired cholesteatoma and examine current diagnosis and management strategies in detail.

show abstract

Section: Surgical Treatmentmentioning

confidence: 99%

Updates and Knowledge Gaps in Cholesteatoma Research

Kuo

Shiao

Yung

et al. 2015

BioMed Research International

Self Cite

176

179

View full text Add to dashboard Cite

show abstract

“…Acquired cholesteatoma is a complex and relatively common disorder of the middle ear that was first recognized more than 3 centuries ago . Prevalence is highest among white patients, followed by black patients, with a reported annual incidence of 9.2 to 12.6 cases per 100 000 adults, affecting approximately 5 million people worldwide .…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Acquired cholesteatoma is a complex and relatively common disorder of the middle ear that was first recognized more than 3 centuries ago. 10,11 Prevalence is highest among white patients, followed by black patients, with a reported annual incidence of 9.2 to 12.6 cases per 100 000 adults, affecting approximately 5 million people worldwide. 12 Acquired cholesteatoma is a histologically benign but behaviorally malignant lesion derived from an abnormal growth of keratinizing squamous epithelium in the temporal bone.…”

mentioning

confidence: 99%

Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis

Kuo

Yen

Chang

et al. 2017

JAMA Otolaryngol Head Neck Surg

Self Cite

View full text Add to dashboard Cite

IMPORTANCE Chronic rhinosinusitis (CRS) can cause an obstruction of the tubal orifice and thereby compromise ventilation of the middle ear. The resulting negative pressure in the middle ear may, in turn, lead to the formation of an eardrum retraction pocket and subsequent acquired cholesteatoma. This study hypothesizes that CRS may increase the risk of cholesteatoma. OBJECTIVE To evaluate the risk of cholesteatoma in patients with CRS. DESIGN, SETTING, AND PARTICIPANTS This study used a nationwide, population-based claims database to test the hypothesis that CRS may increase the risk of cholesteatoma. The Longitudinal Health Insurance Database of Taiwan was used to compile data from (1) 12 670 patients with newly diagnosed CRS between January 1, 1997, and December 31, 2002, and (2) a comparison cohort of 63 350 matched individuals without CRS, resulting in a CRS vs control ratio of 1:5. Data analysis was performed from June 1 to October 27, 2015. Each patient was followed up for 8 years to identify those in whom cholesteatoma subsequently developed. The Kaplan-Meier method was used to determine the cholesteatoma-free survival rate, and the log-rank test was used to compare survival curves. Cox proportional hazards regression models were used to compute the 8-year hazard ratios (HRs). MAIN OUTCOMES AND MEASURES Diagnosis of cholesteatoma. RESULTS Among the 76 020 patients enrolled in this study, 35 220 (46.3%) were female; mean (SD) age was 27.57 (22.03) years. A total of 209 patients developed cholesteatoma, 66 (101 084 person-years) individuals from the CRS cohort and 143 (506 540 person-years) from the comparison cohort were diagnosed with cholesteatoma during the 8-year follow-up period. The incidence of cholesteatoma per 1000 person-years was more than twice as high among patients with CRS (0.65; 95% CI, 0.50-0.81 person-years) than among those without CRS (0.28; 95% CI, 0.24-0.33). The absolute difference in the incidence density between CRS and non-CRS group was 0.37 (95% CI, 0.21-0.53) per 1000 patient-years. After adjusting for potential confounders, patients with CRS had a 69% increased risk of cholesteatoma within 8 years, compared with those without CRS (HR, 1.69; 95% CI, 1.23-2.32). Patients with CRS presented a significantly lower 8-year cholesteatoma-free survival rate than did those in the comparison group. The absolute difference in the 8-year cholesteatoma-free survival rate between the CRS and non-CRS groups was 0.0029 (95% CI, 0.0016-0.0043). CONCLUSIONS AND RELEVANCE This is the first large-scale study, to date, to demonstrate a prospective link between CRS and the subsequent development of cholesteatoma within a follow-up period of 8 years. The purpose of the study was to draw attention to the possibility of development of cholesteatoma among patients with CRS. Because that possibility exists, clinicians should keep this association in mind as well as the importance of a thorough head and neck examination.

show abstract