Operative management of external auditory canal cholesteatoma: case series and literature review

Sayles, Mark; Kamel, H A; Fahmy, F.

doi:10.1017/s0022215113001850

Cited by 22 publications

(14 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The formation of EAC cholesteatoma is consid-10 J Int Adv Otol 2017; 13(1): 9-13 Table 1. External auditory canal cholesteatoma: The classification was proposed by Naim et al [1] Stage I Hyperplasia and hyperemia of the auditory meatal epithelium ered to be via "keratinization in situ, " which is a reduction in migratory capacity of epithelium [1,3,6,12] . Same as the vascular distribution, the direction of epithelial migration is outward from the manubrium of malleus to annulus [1] .…”

Section: Discussionmentioning

confidence: 99%

“…However, the bony destruction of EAC and involvement of adjacent structures can occur in advanced diseases. If EAC cholesteatoma invades the mastoid cavity, it may damage the fallopian canal, semicircular canals, and sigmoid sinus [3,5,6] . The temporal-mandibular joint would then be affected through the anterior aspect of EAC [6,15,16] .…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms of EAC cholesteatoma are indolent and nonspecific. Patients with EAC cholesteatoma commonly complain of unilateral otorrhea and otalgia; however, unilateral hearing impairment has rarely been reported [3,4] .…”

Section: Introductionmentioning

confidence: 99%

“…The locally invasive expansion of EAC cholesteatoma can cause the destruction of the adjacent structures, and if the mastoid cavity is invaded, facial nerve paralysis and labyrinthine fistula can occur [3,5,6] . Destruction through the anterior wall of EAC can affect the temporal-mandibular joint [1] , and advanced invasion of the skull base can induce meningitis or an intracranial abscess [7] .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Surgical Treatment of External Auditory Canal Cholesteatoma - Ten Years of Clinical Experience

Huang

Tsai³

et al. 2017

Int Adv Otol

View full text Add to dashboard Cite

[8,9] . The aim of this study was to describe the clinical manifestations of EAC cholesteatoma and to present our experience of surgical management in such patients. MATERIALS and METHODSA total of 28 patients (30 surgical ears) were enrolled from January 2004 to December 2013. All patients underwent a detailed medical examination, medical history review, and a battery of tests including pure tone audiometry and high-resolution computed tomography (CT) of the temporal bone. This study was approved by the institutional review board. 9Surgical Treatment of External Auditory Canal Cholesteatoma -Ten Years of Clinical Experience OBJECTIVE: To describe the clinical manifestations of external auditory canal (EAC) cholesteatoma and evaluate the surgical outcomes of reconstruction using an inferior pedicled soft-tissue periosteum flap. MATERIALS and METHODS:A total of 28 patients were enrolled in this retrospective study conducted at Kaohsiung Medical University Hospital in Taiwan between January 2004 and December 2013. EAC cholesteatoma was classified according to the disease extent. The surgery was performed to reconstruct a smooth contour of EAC. RESULTS:The average age of the 28 patients (9 males and 19 females: 30 surgical ears) was 53.7 years. The most common clinical manifestations were unilateral otalgia (63.3%) and otorrhea (46.7%), and the most frequent locations of EAC cholesteatoma with bony invasion were the posterior-inferior (40%), inferior (30%), posterior (20%), and posterior-inferior-anterior (10%) aspects. Based on Naim's staging systems of EAC cholesteatoma, 26 ears (86.7%) were classified as stage III and 4 ears (13.3%) as stage IV. All patients received surgical management via a postauricular approach, and the average length of postoperative follow-up was 61.5 months (range 8-131 months). One patient had recurrence after surgery for 1 year 3 months. CONCLUSION:Bony canaloplasty and obliteration with an inferior pedicled soft-tissue periosteum flap is a reliable procedure for EAC cholesteatoma.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Treatment of External Auditory Canal Cholesteatoma - Ten Years of Clinical Experience

Huang

Tsai³

et al. 2017

Int Adv Otol

View full text Add to dashboard Cite

show abstract

“…Patients with stenosis sizes of 2 mm or less are at high risk for developing cholesteatoma and should undergo surgery; however, the data in the present study challenged this viewpoint. To date, there are no large sample studies focusing on the clinical features and long-term outcomes of CAS, and no studies have described the important parameter of measuring the diameter of EAC [5][6][7][8][9][10][11] . The aim of the present study was to comprehensively evaluate the clinical features and long-term outcomes of CAS, and challenge the previous viewpoint.…”

mentioning

confidence: 99%

Congenital Aural Stenosis: Clinical Features and Long-term Outcomes

Chen

et al. 2016

J. Laryngol. Otol.

View full text Add to dashboard Cite

The aim of the present study was to comprehensively evaluate the clinical features and long-term outcomes of congenital aural stenosis (CAS). This study presents a retrospective review of patients who underwent meatoplasty for CAS at a tertiary referral hospital from 2008 to 2015. A total of 246 meatoplasty procedures were performed on 232 patients in the present study. We performed multivariate regression analysis. Except in the age < 6 years group, no significant difference was observed among different age groups for cholesteatoma formation, p > 0.05. Except for the stenosis of the external auditory canal (EAC) (>4 mm) group, the other stenosis of EAC groups were not associated with cholesteatoma formation, p > 0.05. Postoperative air-bone gaps (ABG) less than 30 dB occurred in 77.3% (99/128) of the patients, and the Jahrsdoerfer score was associated with postoperative ABG, p < 0.001. The complication rate of CAS was 13.8% (20/144), and males showed a higher risk for postoperative complications (OR, 6.563; 95% CI, 1.268-33.966, p = 0.025). These results indicate that meatoplasty was an effective surgical intervention for CAS, showing a stable hearing outcome with prolonged follow-up. There was no significant difference between the cholesteatoma and no cholesteatoma groups for hearing outcomes, p > 0.05.Congenital aural stenosis (CAS) carries a much greater risk of cholesteatoma compared with congenital aural atresia (CAA). Cole and Jahrsdoerfer defined CAS as an external auditory canal (EAC) with a diameter of 4 mm or less that frequently occurs in conjunction with grade 1 and grade 2 microtia. This diameter was selected because none of the patients with canal openings larger than 4 mm developed cholesteatoma 1,2 . The diagnosis of CAS is based on clinical examination (anamnesis, physical and audiometric evaluation) and imaging, particularly high-resolution computed tomography (HRCT) of the temporal bones 3 . The treatment of EAC cholesteatoma depends on the extent of the disease. Small lesions can typically be controlled with regular debridement, combined with the administration of topical antibiotics, while large and destructive lesions require surgery 4 . The data on patients with CAS are limited, and the fundamental knowledge of CAS is still based on Cole and Jahrsdoerfer (1990). Two important parameters to consider when managing with CAS are patient age and stenosis size 1 . Patients with stenosis sizes of 2 mm or less are at high risk for developing cholesteatoma and should undergo surgery; however, the data in the present study challenged this viewpoint. To date, there are no large sample studies focusing on the clinical features and long-term outcomes of CAS, and no studies have described the important parameter of measuring the diameter of EAC [5][6][7][8][9][10][11] . The aim of the present study was to comprehensively evaluate the clinical features and long-term outcomes of CAS, and challenge the previous viewpoint. Previous studies analysing the clinical features of CAS involved small sample sizes,...

show abstract

Spontaneous External Auditory Canal Cholesteatoma: Case Series and Review of Literature

Dhingra

Pusalkar

2019

Indian J Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

Operative management of external auditory canal cholesteatoma: case series and literature review

Cited by 22 publications

References 19 publications

Surgical Treatment of External Auditory Canal Cholesteatoma - Ten Years of Clinical Experience

Surgical Treatment of External Auditory Canal Cholesteatoma - Ten Years of Clinical Experience

Congenital Aural Stenosis: Clinical Features and Long-term Outcomes

Spontaneous External Auditory Canal Cholesteatoma: Case Series and Review of Literature

Contact Info

Product

Resources

About