AI Article Synopsis
- The study aimed to compare radiographic evidence of cholesteatoma in the retrotympanum to actual findings during surgery, assessing how useful these imaging results are in clinical practice.
- Involved 76 patients who underwent surgery for cholesteatoma, with preoperative imaging analyzed against intraoperative observations to see how accurately the imaging predicted the extent of the disease.
- Findings indicated significant overestimations in several areas regarding the cholesteatoma's extent on scans compared to what was found during surgery, suggesting that radiological assessments may not be as reliable as previously thought.
Article Abstract
Objective: To correlate radiographic evidence of cholesteatoma in the retrotympanum with intraoperative endoscopic findings in cholesteatoma patients and to evaluate the clinical relevance of radiographic evidence of cholesteatoma in the retrotympanum.
Study Design: Case series with chart review.
Setting: Tertiary referral center.
Methods: Seventy-six consecutive cases undergoing surgical cholesteatoma removal with preoperative high-resolution computed tomography (HRCT) were enrolled in this study. A retrospective analysis of the medical records was conducted. The extension of cholesteatoma regarding different middle ear subspaces, into the antrum and mastoid were reviewed radiologically in preoperative HRCT and endoscopically from surgical videos. Additionally, facial nerve canal dehiscence, infiltration of the middle cranial fossa, and inner ear involvement were documented.
Results: Comparison of radiological and endoscopic cholesteatoma extension revealed statistically highly significant overestimation of radiological cholesteatoma extension for all retrotympanic regions (sinus tympani 61.8% vs 19.7%, facial recess 69.7% vs 43.4%, subtympanic sinus 59.2% vs 7.9%, and posterior sinus 72.4% vs 4.0%) and statistically significant overestimation for mesotympanum (82.9% vs 56.6%), hypotympanum (39.5% vs 9.2%), and protympanum (23.7% vs 6.6%). No statistically significant differences were found for epitympanum (98.7% vs 90.8%), antrum (64.5% vs 52.6%), and mastoid (26.3% vs 32.9%). Statistically significant radiological overestimation of facial nerve canal dehiscence (54.0% vs 25.0%) and invasion of tegmen tympani (39.5% vs 19.7%) is reported.
Conclusion: Radiologic cholesteatoma extension in different middle ear subspaces is overestimated compared to the intraoperative extension. The preoperative relevance of radiological retrotympanic extension might be limited in the choice of approach and transcanal endoscopic approach is always recommended first.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/ohn.413 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparison of current staging systems for predicting pediatric cholesteatoma outcomes.
Int J Pediatr Otorhinolaryngol
December 2024
Department of Otolaryngology, University of Minnesota, Minneapolis, MN, USA; HealthPartners Medical Group, St. Paul, MN, USA. Electronic address:
Article Synopsis
- This study evaluates the effectiveness of two staging systems (EAONO-JOS and Potsic) in predicting recurrence of cholesteatoma in children with different types (congenital, primary acquired, and secondary acquired).
- Conducted from 2015 to 2023, the research analyzed surgical outcomes from 31 ears in 30 pediatric patients, examining variables like residual disease and factors like stapes erosion that might signal recidivism.
- Results indicated high rates of residual disease, particularly in congenital and primary acquired cases, and found a potential correlation between certain variables and poorer outcomes; however, limitations in the staging systems decreased the predictivity for residual disease.
Myoepithelial Carcinoma of the External Auditory Canal With Extension Into the Middle Ear and Mastoid.
J Craniofac Surg
October 2024
Department of Otolaryngology-Head and Neck Surgery, Southwest Ohio ENT, Dayton, OH.
Myoepithelial carcinoma is a rare disease of the head and neck, with only a handful of cases reported occurring within the external auditory canal, middle ear, and mastoid. The patient discussed is a 67-year-old male with a prior history of a bilateral tympanomastoidectomy for cholesteatoma and a prior history of left parotidectomy and adjuvant radiation for pleomorphic sarcoma. Three years after the parotidectomy, the patient presented with contralateral ear fullness.
View Article and Find Full Text PDFDoes the ChOLE classification relate to the duration of surgery?
Eur Arch Otorhinolaryngol
October 2024
Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 50924, Cologne, Germany.
Introduction: Cholesteatoma, a challenging entity in otologic surgery, necessitates a standardized classification system for effective communication among healthcare providers and consistent reporting of surgical outcomes. The ChOLE Classification System, introduced by Linder et al., stages cholesteatoma based on extension (Ch), ossicular chain status (O), life-threatening complications (L), and Eustachian tube function and mastoid pneumatization (E).
View Article and Find Full Text PDFExclusive endoscopic tympanoplasty efficacy in the treatment of cholesteatoma without mastoid involvement.
Eur Arch Otorhinolaryngol
November 2024
University of Verona, Via dell'Artigliere 8, Verona, 37129, Italy.
Purpose: The purpose of this study is to determine the recurrence rate of cholesteatoma in patients who have undergone exclusive endoscopic tympanoplasty at our tertiary referral institution. A secondary objective is to analyze different clinical aspects that could be considered risk factors for recurrence to establish if it is possible to determine when a second-look procedure is indicated instead of a clinical follow-up.
Methods: A retrospective study was performed on patients who had undergone exclusive endoscopic tympanoplasty for cholesteatoma in the last eight years and who were followed up for at least one year.
Management of Cholesteatoma: Extension Beyond Middle Ear/Mastoid.
Otolaryngol Clin North Am
February 2025
Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
Petrous bone cholesteatoma, or cholesteatoma that extends beyond the middle ear and mastoid, represents a rare but destructive pathology. Diagnosis can be difficult before substantial morbidity is incurred, and patients can present with life-threatening complications. Determination of disease extent and the functional status of the facial nerve and cochleovestibular system are critical in surgical planning.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!