Surgical management of external auditory canal lesions

2013 ◽  
Vol 127 (3) ◽  
pp. 246-251 ◽  
Author(s):  
P M Spielmann ◽  
S McKean ◽  
R D White ◽  
S S M Hussain
Keyword(s):  
Surgical Management ◽  
External Auditory Canal ◽  
Case Series ◽  
Surgical Excision ◽  
Subsequent Treatment ◽  
Malignant Neoplasms ◽  
Cavernous Haemangioma ◽  
Bony Lesions ◽  
External Auditory Canal Cholesteatoma ◽  
Personal Case

AbstractBackground:Lesions arising in the external auditory canal that require surgical excision are uncommon. They are associated with a range of pathologies, including bony abnormalities, infections, benign and malignant neoplasms, and epithelial disorders.Methods:This paper describes a 10-year personal case series of external auditory canal lesions with chart, imaging and histopathology review.Results:In total, 48 lesions required surgical management, consisting of: 13 bony lesions; 14 infective lesions; 14 neoplasms with 11 histological types (including ceruminous adenoma and the extremely rare cavernous haemangioma); 3 epithelial abnormalities; and 4 other benign lesions. The surgical management is described.Conclusion:This study emphasises the diagnostic differences between exostoses and osteomas, and between external auditory canal cholesteatoma and keratosis obturans. It also discusses the management of aural polyps, and highlights the need to excise external auditory canal masses for histology in order to guide subsequent treatment.

scholarly journals Transcanal Endoscopic Ear Surgery with Piezoelectric Device for External Auditory Canal Lesions

2021 ◽  
Vol 64 (7) ◽  
pp. 511-516
Author(s):  
Chan Young Lee ◽  
Seung Ho Kim ◽  
Jeong Hwan Choi
Keyword(s):  
External Auditory Canal ◽  
Cold Water ◽  
Surgical Excision ◽  
Cystic Mass ◽  
Surgical Removal ◽  
Ear Surgery ◽  
Dental Surgery ◽  
Piezoelectric Device ◽  
External Auditory Canal Cholesteatoma ◽  
Conductive Hearing

External auditory canal exostosis (EACE) is prone to occur in patients frequently exposed to cold water, which causes earwax impaction, recurrent otitis externa, and conductive hearing loss. The main treatment for symptomatic EACE is surgical excision. External auditory canal cholesteatoma (EACC) is a bone-destructive cystic mass caused by accumulation of plugs of desquamated keratin debris in the external auditory canal (EAC), which is also mainly treated with surgical removal. The main difficulties in the surgical removal of obstructive EACEs or EACCs are related to the adjacency of EAC skin, tympanic membrane, temporomandibular joint, and the blockage of the medial EAC landmarks during the operation. The piezoelectric device (PZD), which has long been used to cut bony structures in dental surgery, has clinical advantages here with regards to accurate exclusive bone cutting ability and minimal heat production. We report a series of cases that managed EAC lesions using PZD.

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

2013 ◽  
Vol 127 (9) ◽  
pp. 859-866 ◽  
Author(s):  
M Sayles ◽  
H A Kamel ◽  
F F Fahmy
Keyword(s):  
External Auditory Canal ◽  
Case Series ◽  
Operative Management ◽  
External Ear ◽  
Ear Canal ◽  
Female Ratio ◽  
External Ear Canal ◽  
Temporal Bones ◽  
External Auditory Canal Cholesteatoma ◽  
Male To Female

AbstractObjectives:To describe the clinical features of external auditory canal cholesteatoma, and to assess the outcome following bony meatoplasty with tragal cartilage and perichondrium graft repair.Methods:A retrospective review was carried out, comprising all patients with external auditory canal cholesteatoma who presented between January 2007 and December 2011. Patients underwent pre-operative audiometry and computed tomography imaging of the temporal bones, before undergoing bony meatoplasty via a postauricular incision. Pre- and post-operative comparisons were made of patients' otological symptoms and the otoscopic appearance of the external ear canal.Results and conclusion:Eight patients were included in the analyses. The median age of patients was 46.5 years (range 14–68 years), with a male to female ratio of 1:1. The median length of follow up was 16 months. The most common presenting features were unilateral otalgia and purulent otorrhoea. All patients had relatively advanced disease at presentation, with erosion of the temporal bone. All patients underwent bony meatoplasty via a postauricular approach to eradicate the disease. Bony meatoplasty was successful in the definitive management of external ear canal cholesteatoma.

scholarly journals An Initial Overview of Management and Treatment Outcomes for Head and Neck Hemangiomas

2018 ◽  
Vol 32 (2) ◽  
pp. 30-33
Author(s):  
Rodolfo U. Fernandez
Keyword(s):  
Radiofrequency Ablation ◽  
Head And Neck ◽  
Surgical Management ◽  
Vascular Tissue ◽  
Case Series ◽  
Surgical Excision ◽  
Capillary Hemangioma ◽  
University Hospital ◽  
Treatment Modalities ◽  
Complete Excision

Objective: To provide an initial overview of the outcomes of different treatment modalities used for hemangiomas. Methods: Design:           Case Series Setting:           Tertiary National University Hospital Participants: Records of 21 patients diagnosed with head and neck hemangiomas in the Philippine General Hospital Department of Otorhinolaryngology from 2009 to 2014 were reviewed. Results: Majority of the patients were female (61.9%) and in the pediatric age group (57.1%). Of the 21 patients, 6 underwent medical management, 13 had surgical management, 1 had both medical and surgical management, and 1 opted to observe the lesion. All patients treated with propranolol observed a decrease in the size of the lesion. Seven out of the 13 patients had radiofrequency ablation; all had gross residual lesion. Six of the 13 underwent excision, with complete excision being achieved in 5 of 6 cases. Conclusion: Treatment response of patients in this series with hemangiomas of the head and neck to propranolol at a dose of 1 to 2 mg/kg/day may reflect international data. Outcomes analysis for radiofrequency ablation and surgical excision requires a longer duration of follow-up.   Keywords: propranolol hydrochloride, prednisone, pulsed radiofrequency treatment, capillary hemangioma, vascular tissue neoplasms  

Clinical analysis on surgical management of type III external auditory canal cholesteatoma: a report of 12 cases

2016 ◽  
Vol 136 (10) ◽  
pp. 1006-1010 ◽  
Author(s):  
Yan Yan ◽  
Siqi Dong ◽  
Qingqing Hao ◽  
Riyuan Liu ◽  
Guangyu Xu ◽  
...  
Keyword(s):  
Surgical Management ◽  
External Auditory Canal ◽  
Clinical Analysis ◽  
Type Iii ◽  
External Auditory Canal Cholesteatoma

scholarly journals Case series on external auditory canal cholesteatoma: an entity often misdiagnosed

2020 ◽  
Vol 6 (6) ◽  
pp. 1179
Author(s):  
Priti S. Hajare ◽  
O. Padmavathy
Keyword(s):  
Rare Disease ◽  
Clinical Examination ◽  
External Auditory Canal ◽  
Case Series ◽  
Normal Hearing ◽  
External Ear ◽  
Radiological Investigation ◽  
Proper Management ◽  
External Auditory Canal Cholesteatoma

<p class="abstract">External auditory canal cholesteatoma (EACC) is a rare disease. EACC presents with chronic dull aching pain with normal hearing. It is diagnosed by clinical examination and radiological investigation. Due to its rarity it is important to differentiate it from other external ear conditions. We prospectively analysed four cases of cholesteatoma of the external auditory canal in a period of 18 months. All of our patients underwent surgery. In three cases, the cholesteatoma was restricted to the external auditory canal, while in one case it was extending into the antrum. A proper clinical examination with radiological investigations will be helpful in the diagnosis and for proper management of the disease.</p>

scholarly journals SURGICAL MANAGEMENT OF GENERALIZED GINGIVAL ENLARGEMENT – A CASE SERIES

2016 ◽  
Vol 20 (3) ◽  
Author(s):  
Muhammad Usman Akhtar ◽  
Asif Nazir ◽  
Samera Kiran
Keyword(s):  
Surgical Management ◽  
Tertiary Care ◽  
Maxillofacial Surgery ◽  
Case Series ◽  
Surgical Excision ◽  
Oral And Maxillofacial Surgery ◽  
Lack Of Information ◽  
Dental Practitioners ◽  
Gingival Enlargement ◽  
Tertiary Care Centers

Introduction:  Generalized gingival enlargement is characterized by massive and exuberant gingival over-growth that poses social, aesthetic, phonetic and functional problems for the patient. Therefore, it requires meticulous management.Objective:  To describe the surgical management of generalized gingival enlargement by electrosurgical excision of patients presenting to a tertiary care centre.Study Design:  Case series.Materials and Methods:  The study was conducted at the Department of Oral and Maxillofacial Surgery, de’Montmorency College of Dentistry, Lahore, from January 2010 to December 2012. A total of sixteen patients were operated by using electrosurgical approach under general anaesthesia for surgical excision of generalized gingival enlargement.Results:  All of the sixteen patients, 11 males and 5 females, showed excellent healing postoperativelywithout any recurrent gingival overgrowth.Discussion:  To the best of our knowledge, the current study presents the largest case series of generalized gingival enlargement. Most of these cases were with massive disease due to lack of information of the study population about their disease, delay in referral by the general dental practitioners, painless and innocent nature of the problem. Early referral of such patients to tertiary care centers can prevent the patients from social and psychological embarrassment.Conclusion:  Electrosurgical excision is an excellent surgical technique for management of generalized gingival enlargement. Moreover, cross comparative studies are required to establish some diagnostic and therapeutic standards for such patients.

scholarly journals Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712199455
Author(s):  
Nicola Maffulli ◽  
Francesco Oliva ◽  
Gayle D. Maffulli ◽  
Filippo Migliorini
Keyword(s):  
Surgical Management ◽  
Revision Surgery ◽  
Case Series ◽  
Sports Participation ◽  
Patellar Tendinopathy ◽  
Symptom Duration ◽  
Level Of Evidence ◽  
Training Time ◽  
The Mean

Background: Tendon injuries are commonly seen in sports medicine practice. Many elite players involved in high-impact activities develop patellar tendinopathy (PT) symptoms. Of them, a small percentage will develop refractory PT and need to undergo surgery. In some of these patients, surgery does not resolve these symptoms. Purpose: To report the clinical results in a cohort of athletes who underwent further surgery after failure of primary surgery for PT. Study Design: Case series; Level of evidence, 4. Methods: A total of 22 athletes who had undergone revision surgery for failed surgical management of PT were enrolled in the present study. Symptom severity was assessed through the Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P) upon admission and at the final follow-up. Time to return to training, time to return to competition, and complications were also recorded. Results: The mean age of the athletes was 25.4 years, and the mean symptom duration from the index intervention was 15.3 months. At a mean follow-up of 30.0 ± 4.9 months, the VISA-P score improved 27.8 points ( P < .0001). The patients returned to training within a mean of 9.2 months. Fifteen patients (68.2%) returned to competition within a mean of 11.6 months. Of these 15 patients, a further 2 had decreased their performance, and 2 more had abandoned sports participation by the final follow-up. The overall rate of complications was 18.2%. One patient (4.5%) had a further revision procedure. Conclusion: Revision surgery was feasible and effective in patients in whom PT symptoms persisted after previous surgery for PT, achieving a statistically significant and clinically relevant improvement of the VISA-P score as well as an acceptable rate of return to sport at a follow-up of 30 months.

scholarly journals 766. Everything Old is New Again-A Case Series of New World Leishmaniasis in African Children in Portland, Maine

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S428-S428
Author(s):  
Jennifer Jubulis ◽  
Amanda Goddard ◽  
Elizabeth Seiverling ◽  
Marc Kimball ◽  
Carol A McCarthy
Keyword(s):  
Latin America ◽  
Cutaneous Leishmaniasis ◽  
New World ◽  
Pediatric Patients ◽  
Data Extraction ◽  
Clinical Manifestations ◽  
Case Series ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Travel History

Abstract Background Leishmaniasis has many clinical manifestations and treatment regimens, dependent on species and host. Old world leishmaniasis is found primarily in Africa and Asia, and is associated with visceral disease, while new world disease, seen primarily in Latin America, is more commonly mucocutaneous. We present a case series of pediatric African patients with New World cutaneous leishmaniasis (NWCL). Methods Data extraction was performed via chart review, analyzing travel history, clinical presentation, diagnosis, and management in children with cutaneous leishmaniasis presenting to the pediatric infectious diseases clinic in Portland, ME. Biopsy specimens were sent to the federal CDC for identification by PCR and culture. Results Five cases of NWCL were diagnosed in pediatric patients in Maine from November 2018 through February 2020. Median age of patients was 10 years (range 1.5-15 years). Four cases (80%) occurred in children from Angola or Democratic Republic of Congo, arriving in Maine via Central/South America, with one case in a child from Rwanda who arrived in Maine via Texas. Three patients had multiple skin lesions and two had isolated facial lesions. Leishmaniasis was not initially suspected resulting in median time to diagnosis of 5 months (range 1-7 months). Four patients were initially treated with antibacterials for cellulitis and one was treated with griseofulvin. After no improvement, patients underwent biopsy with 2 patients diagnosed with L panamensis, 1 with L braziliensis, 1 with mixed infection (L panamensis and L mexicana), and 1 with Leishmania species only. One patient was managed with surgical excision, 3 with ketoconazole, and 1 was observed off therapy. Four patients were referred to otolaryngology. All continue to be followed in infectious disease clinic. Conclusion We present five cases of new world cutaneous leishmaniasis in African pediatric patients arriving to Maine through Latin America or Texas. Patients were diagnosed with cellulitis, tinea corporis or atopic dermatitis initially, underscoring importance of high index of suspicion in migrant patients. Detailed travel history and epidemiologic knowledge is essential to diagnosis, as patients may present with illness not congruent with country of origin. Optimal therapy remains unclear. Disclosures All Authors: No reported disclosures

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