Modified sleeve tympanotomy approach for removal of congenital cholesteatoma

2008 ◽  
Vol 122 (12) ◽  
pp. 1365-1367 ◽  
Author(s):  
H J Park ◽  
G H Park ◽  
J E Shin ◽  
S O Chang

AbstractObjective:We present a technique which we have found useful for the management of congenital cholesteatoma extensively involving the middle ear.Case report:A five-year-old boy was presented to our department for management of a white mass on the right tympanic membrane. This congenital cholesteatoma extensively occupied the tympanic cavity. It was removed through an extended tympanotomy approach using our modified sleeve technique. The conventional tympanotomy approach was extended by gently separating the tympanic annulus from its sulcus in a circular manner. The firm attachment of the tympanic membrane at the umbo was not severed, in order to avoid lateralisation of the tympanic membrane.Conclusion:Although various operative techniques can be used, our modified sleeve tympanotomy approach provides a similarly sufficient and direct visualisation of the entire middle ear, with, theoretically, no possibility of lateralisation of the tympanic membrane and subsequent conductive hearing loss.

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
D. Isenring ◽  
T. F. Pezier ◽  
B. Vrugt ◽  
A. M. Huber

Introduction. Despite modern radiological workup, surgeons can still be surprised by intraoperative findings or by the pathologist’s report.Materials & Methods. We describe the case of a 52-year-old male who was referred to our clinic with a single sided conductive hearing loss. He ultimately underwent middle ear exploration and excision of a middle ear tumour followed by second look and ossiculoplasty a year later.Results. Though preoperative CT and MRI scanning were suggestive of a congenital cholesteatoma, the pathologist’s report diagnosed a middle ear adenoma.Discussion. Middle ear glandular tumors are extremely rare and, despite numerous histological techniques, continue to defy satisfactory classification. Most surgeons advocate surgical excision though evidence of the tumour’s natural course and risk of recurrence is lacking.


2009 ◽  
Vol 124 (6) ◽  
pp. 680-683 ◽  
Author(s):  
J H Lee ◽  
S H Jung ◽  
H C Kim ◽  
C H Park ◽  
S M Hong

AbstractObjective:We report a case of bilateral conductive hearing loss caused by stapedial suprastructure fixation with normal footplate mobility.Case report:A 50-year-old woman had suffered hearing loss in both ears since childhood. Exploratory tympanotomy revealed immobility of the stapes due to a bony bridge between the stapedial suprastructure and the fallopian canal. The incus was missing, while the malleus handle was minimally deformed. The mobility of the stapes footplate was normal. Post-operatively, the hearing in the right ear improved both subjectively and audiographically, while that in the left ear did not improve because of footplate subluxation during surgery.Conclusion:This is a rare case of congenital stapedial suprastructure fixation with normal footplate mobility. In this patient, development of the second branchial arch was arrested. When performing exploratory tympanotomy for stapedial fixation, one must keep in mind that normal footplate mobility is possible.


2005 ◽  
Vol 84 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Michael C. Neuenschwander ◽  
Ellen S. Deutsch ◽  
Anthony Cornetta ◽  
Thomas O. Willcox

Penetrating middle ear injury can result in hearing loss, vertigo, and facial nerve injury. We describe the cases of 2 children with penetrating trauma to the right ear that resulted in ossicular chain disruption; one injury was caused by cotton-tipped swabs and the other by a wooden matchstick. Symptoms in both children included hearing loss and otalgia; in addition, one child experienced ataxia and the other vertigo. Physical examination in both cases revealed a perforation in the posterosuperior quadrant of the tympanic membrane and visible ossicles. Audiometry identified a moderate conductive hearing loss in one child and a mild sensorineural hearing loss in the other. Both children underwent middle ear exploration and reduction of a subluxed stapes. We discuss the diagnosis, causes, and management of penetrating middle ear trauma. To reduce the morbidity associated with these traumas, otologic surgeons should act promptly and be versatile in choosing methods of repairing ossicular chain injuries.


2012 ◽  
Vol 126 (12) ◽  
pp. 1276-1277
Author(s):  
A R Kakeri ◽  
A H Patel

AbstractObjective:We report an extremely rare case of primary otoscleroma.Method:We present a case report and a review of the world literature concerning otoscleroma.Results:An adult woman presented with chronic suppurative otitis media with tubotympanic disease and conductive hearing loss. On mastoid exploration, dark granulations were seen, which were identified as otoscleroma on histopathological examination. The patient responded well to streptomycin.Conclusion:To the best of our knowledge, this is the first report of primary otoscleroma in the world literature. This case indicates that Frisch's bacillus can also spread to the middle ear.


2021 ◽  
pp. 014556132199502
Author(s):  
Jana Jančíková ◽  
Soňa Šikolová ◽  
Josef Machač ◽  
Marta Ježová ◽  
Denisa Pavlovská ◽  
...  

Salivary gland choristoma is an extremely rare middle ear pathology. We present the case of a 10-year-old girl with unilateral conductive hearing loss. Tympanotomy showed a nonspecific middle ear mass, absence of stapes, anomaly of incus, and displaced facial nerve. It was not possible to remove the mass completely. Histology confirmed salivary gland choristoma. The hearing in this case can be improved with a bone-anchored hearing aid.


2019 ◽  
Vol 133 (12) ◽  
pp. 1107-1109
Author(s):  
S Gülşen

AbstractObjectiveThis case report presents a middle-ear osteoma mimicking otosclerosis that was located at the promontory. The osteoma was successfully excised using an endoscopic transcanal approach without any complication.Case reportA 21-year-old man presented with a 4-year history of progressive conductive hearing loss (47 dB with a 30-dB air–bone gap) with intermittent tinnitus of recent onset in his right ear. Endoscopic transcanal middle-ear exploration showed that an osteoma located on the promontory was restricting the mobility of the stapes by affecting the anterior crus of the stapes. After transcanal resection of the osteoma, pure tone audiometry improved to 23 dB with a 5-dB air–bone gap. Tinnitus resolved spontaneously without any additional treatment.ConclusionPromontory osteomas, a rare and usually asymptomatic clinical entity, should be taken into consideration in the differential diagnosis in patients with progressive conductive hearing loss and tinnitus with intact stapedial reflexes and normal otoscopic findings.


2012 ◽  
Vol 132 (6) ◽  
pp. 618-623 ◽  
Author(s):  
Se-Hyung Kim ◽  
Yang-Sun Cho ◽  
Ho-suk Chu ◽  
Jeon-Yeob Jang ◽  
Won-Ho Chung ◽  
...  

Author(s):  
Shankar Bettadapura Govindan ◽  
Yogeshwar Chandrashekar

<p class="abstract"><strong>Background:</strong> Determining the cause of conductive hearing loss with an intact tympanic membrane has been a challenge for the otologists for over decades<strong>. </strong>The aim of this study is to ascertain the usefulness of endoscopes to study the various middle ear pathologies on performing endoscopic exploratory tympanotomy.</p><p class="abstract"><strong>Methods:</strong> A retrospective analysis of various pathologies encountered in the middle ear in 88 patients who underwent endoscopic exploratory tympanotomy done over a study period of 3.5 years (January 2015 to June 2018).  </p><p class="abstract"><strong>Results:</strong> In our study, age of the patients ranged from 14 to 50 years with a mean age of 32 years. Most common finding on exploration was otosclerosis in 59 patients followed by revision stapedotomy in 12 patients. 5 patients had normal middle ear findings with all ossicles intact and mobile while other pathologies encountered were tympanosclerosis (4.6%), biscuit foot plate (2.3%), mucosal bands (3.4%) and middle ear developmental anomalies (3.4%).</p><p class="abstract"><strong>Conclusions:</strong> On exploring the middle ear<strong> </strong>knowing the various aetiologies helps in better preoperative counseling of the patients for the outcome of surgery. Endoscopic approach for exploratory tympanotomy has the benefit of excellent resolution with higher magnification and wider panoramic view of middle ear anatomy.</p><p> </p>


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