Gegenw�rtige Theorien zur Cholesteatomentstehung

Sudhoff, Holger; Hildmann, H.

doi:10.1007/s00106-002-0770-1

Cited by 11 publications

(3 citation statements)

References 36 publications

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“…Depending on the character of lesions to the middle ear mucous, different types of this abnormality are distinguished: simple chronic otitis media, chronic cholesteatoma otitis media, chronic granulomatous otitis media, and chronic otitis media associated with specific diseases. Particularly notable is the occurrence of cholesteatoma and granulation tissue, which are characterized by a tendency to damage the bone tissue, implying the risk of otogenic intracranial and intratemporal complications ( Figure 1 ) [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of Change in Air-Bone Gap and Bone Conduction in Patients Operated on for Chronic Otitis Media

Wiatr

Składzień

et al. 2015

Med Sci Monit

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BackgroundMiddle ear surgery aims to eliminate pathology from the middle ear, improve drainage and ventilation of the postoperative cavity, and reconstruct the tympanic membrane and ossicles.The aim of this work is to define the factors that affect ABG (air-bone gap) and bone conduction in the patients operated on due to chronic otitis media.Material/MethodsA prospective analysis of patients operated on due to diseases of the middle ear during 2009–2012 was carried out. The cases of patients operated on for the first time due to chronic otitis media were analyzed.The analysis encompassed patients who had undergone middle ear surgery. The patients were divided into several groups taking into account the abnormalities of the middle ear mucous and damage of the ossicular chain observed during otosurgery.ResultsA significant hearing improvement was observed in patients with type 2 tympanoplasty in the course of chronic cholesteatoma otitis media and in patients with simple chronic inflammatory process in whom a PORP was used in the reconstruction. Granulation tissue was an unfavorable factor of hearing improvement following tympanoplasty.A significant improvement of bone conduction was observed in the patients with dry perforation without other lesions in the middle ear.The elimination of granulation lesions was a positive factor for the future improvement of the function of the inner ear.ConclusionsThe presence of granuloma-related lesions in the middle ear spaces is likely to impede hearing improvement.Damage to the ossicular chain rules out the possibility of bone conduction improvement after surgery.The prognosis on tube-related simple chronic otitis media after myringoplasty, with the preserved continuity of the ossicular chain, consists of closing the ABG and leads to significant improvement of bone conduction.

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Section: Introductionmentioning

confidence: 99%

Determinants of Change in Air-Bone Gap and Bone Conduction in Patients Operated on for Chronic Otitis Media

Wiatr

Składzień

et al. 2015

Med Sci Monit

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“…Furthermore, facial paralysis might be caused by erosion of the facial canal and disturbances of the equilibrium organ due to detraction of the semicircular fistulas. Fortified inflammation causes mastoiditis, meningitis, intracranial abscesses, and sinus vein thrombosis [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Guidance for Removal of Cholesteatoma Using a Multispectral 3D-Endoscope

Wisotzky

Rosenthal

Wege

et al. 2020

Sensors

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We develop a stereo-multispectral endoscopic prototype in which a filter-wheel is used for surgical guidance to remove cholesteatoma tissue in the middle ear. Cholesteatoma is a destructive proliferating tissue. The only treatment for this disease is surgery. Removal is a very demanding task, even for experienced surgeons. It is very difficult to distinguish between bone and cholesteatoma. In addition, it can even reoccur if not all tissue particles of the cholesteatoma are removed, which leads to undesirable follow-up operations. Therefore, we propose an image-based method that combines multispectral tissue classification and 3D reconstruction to identify all parts of the removed tissue and determine their metric dimensions intraoperatively. The designed multispectral filter-wheel 3D-endoscope prototype can switch between narrow-band spectral and broad-band white illumination, which is technically evaluated in terms of optical system properties. Further, it is tested and evaluated on three patients. The wavelengths 400 nm and 420 nm are identified as most suitable for the differentiation task. The stereoscopic image acquisition allows accurate 3D surface reconstruction of the enhanced image information. The first results are promising, as the cholesteatoma can be easily highlighted, correctly identified, and visualized as a true-to-scale 3D model showing the patient-specific anatomy.

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“…Cholesteatoma requires a complete resection to avoid recurrence. Especially, the proliferation of this epithelium in the middle ear cavity and further growth into the mastoid and lateral skull base can lead to life-threatening complications [7]. Thus, the goal during surgery is a complete removal while recovering or preserv-ing the hearing ability.…”

Section: Introductionmentioning

confidence: 99%

A multispectral 3D-Endoscope for Cholesteatoma Removal

Wisotzky

Rosenthal

Hilsmann

et al. 2020

Current Directions in Biomedical Engineering

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We present a stereo-multispectral endoscopic prototype using a filter-wheel to guide the removal of cholesteatoma tissue in the middle ear. An image-based method is used that combines multispectral tissue classification for the detection of tissue to be removed and 3Dreconstruction to determine its metric dimensions. The multispectral illumination used for tissue classification ranges from λ = 400 nm to λ = 500 nm with step-size of 20 nm, which results in six different narrow-band illumination modes. For classical RGB imaging and metric calculations, a broadband illumination mode is applied before and after the narrow-band illumination. The spectral information is augmented into the broadband mode using an overlay technique. The combination of multispectral imaging with stereoscopic 3D-reconstruction results in new valuable visualization of intraoperative data. This allows to generate a 3D-model of the patients anatomy highlighting the identified malicious tissue and compare the anatomical dimensions with pre-operative CT data.

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Gegenw�rtige Theorien zur Cholesteatomentstehung

Cited by 11 publications

References 36 publications

Determinants of Change in Air-Bone Gap and Bone Conduction in Patients Operated on for Chronic Otitis Media

Determinants of Change in Air-Bone Gap and Bone Conduction in Patients Operated on for Chronic Otitis Media

Surgical Guidance for Removal of Cholesteatoma Using a Multispectral 3D-Endoscope

A multispectral 3D-Endoscope for Cholesteatoma Removal

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