JAMA Otolaryngol Head Neck Surg
Service of Audiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Published: February 2016
Importance: Several classifications of cholesteatoma exist, but there are controversies about their clinical application.
Objective: To classify cholesteatomas and describe the prevalence of the subtypes.
Design, Setting, And Participants: A cross-sectional comparative study of 414 ears in 356 consecutive patients with middle ear cholesteatoma and no history of ear surgery treated at a tertiary hospital was conducted from March 8, 2000, to March 30, 2015. Data analysis was conducted from March 30, 2014, to March 30, 2015.
Intervention: Otoendoscopy was conducted, and findings for both ears were recorded.
Main Outcomes And Measures: Cholesteatoma growth patterns were classified as anterior epitympanic, posterior epitympanic, posterior mesotympanic, 2 routes (both the pars flaccida and the pars tensa are involved), and undetermined.
Results: Among the 356 patients in this study, mean (SD) patient age was 33.23 (19.81) years (range, 4-82 years), and 125 patients (35.1%) were female. The right ear was identified as the affected ear in 220 patients (61.8%). A total of 272 (65.7%) ears were from adults. Of the 414 ears that underwent otoendoscopy, posterior epitympanic (142 [34.3%]) and posterior mesotympanic (140 [33.8%]) were the most frequent types of cholesteatoma observed, followed by undetermined (67 [16.2%]) and 2 routes (57 [13.8%]). Anterior epitympanic type was the least frequent (8 [1.9%]). Posterior epitympanic cholesteatoma was more prevalent in adults (111 [40.8%]), whereas posterior mesotympanic cholesteatoma was more frequent in children (43.0%) (P < .001). Anterior epitympanic cholesteatoma was observed only in children.
Conclusions And Relevance: Classifying cholesteatomas according to the growth pattern (anterior epitympanic, posterior epitympanic, posterior mesotympanic, 2 routes, and undetermined) includes all existing types of cholesteatomas of the middle ear. In general, the prevalence of posterior epitympanic and posterior mesotympanic cholesteatoma were similar. Whereas anterior epitympanic and posterior mesotympanic cholesteatomas were more prevalent in children, posterior epitympanic cholesteatoma was more frequent in adults.
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http://dx.doi.org/10.1001/jamaoto.2015.3148 | DOI Listing |
J Clin Med
July 2024
Department of Orofacial Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, 1081 Amsterdam, The Netherlands.
The aim of the present study is to identify a more reliable reference point in three-dimensional cephalometric analysis to replace the Porion point used in two-dimensional analysis, enhancing the accuracy of assessments. The methodology assessed potential alternative landmarks for three-dimensional cephalometric analysis. Utilizing a segmenting technique, anatomical landmarks were accurately pinpointed from the external acoustic meatus of 26 Cone Beam Computed Tomography (CBCT) scans.
View Article and Find Full Text PDFLin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
October 2023
For tympanosclerosis patients with ossicular chain fixation, we use ossicular chain bypass technique and evaluate its long-term effects. From June 2017 to June 2019, 147 patients with tympanosclerosis who underwent middle ear surgery with otoscopy in Yinchuan First People's Hospital were reviewed. The subjects were divided into three groups according to the implemented operation plan, 51 cases in the ossicular chain mobilization group(OCM), 56 cases in the ossicular chain bypass reconstruction group(OCB), and 40 cases in the malleus-incus complex resection reconstruction group(MICR).
View Article and Find Full Text PDFRadiol Med
September 2023
Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
Background: Cholesteatoma is caused by disorders of the middle ear ventilation that trigger a progressive series of events responsible for its formation. The aim of this study was to identify possible radiological CT-derived parameters predisposing to ventilation disorders and cholesteatoma.
Methods: In this retrospective study, patients diagnosed with cholesteatomatous chronic otitis media who underwent temporal bone CT and open tympanoplasty surgery have been included, as well as control patients with clinical examination negative for organic otological pathology who underwent temporal bone CT for other reasons.
Eur Arch Otorhinolaryngol
May 2022
Otolaryngology Head and Neck Surgery Department, University of Bologna, Bologna, Italy.
Purpose: To describe the suprameatal-transzygomatic root endoscopic approach (STEA) to the geniculate ganglion (GG), the labyrinthine facial nerve (FN) and epitympanum.
Methods: The feasibility and limits of the STEA, maintaining the integrity of the ossicular chain, were analysed. Ten human cadaveric ears were dissected.
Otol Neurotol
August 2021
Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University.
Objectives: Prussak's space (PS) is an intricate middle ear region which may play an essential role in the development of middle ear disease. The three-dimensional (3D) anatomy of the human PS and its drainage routes remain relatively unknown. Earlier studies have histologically analyzed PS, by micro-dissection and endoscopy.
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