Middle-ear or mastoid granulation pathology associated with retraction of the pars flaccida and low-pitched tinnitus

2021 ◽  
pp. 1-4
Author(s):  
Z Lou
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Ossicular Chain ◽  
Endoscopic Examination ◽  
Canal Wall ◽  
Pars Flaccida ◽  
Surgical Exploration ◽  
Clinical Records ◽  
Canal Wall Up

Abstract Objective This study aimed to evaluate the clinical features and outcomes of patients with middle-ear granulation pathologies associated with attic retractions. Method The clinical records of adult patients with middle-ear granulation pathologies and attic retractions confirmed via computed tomography and surgical exploration between January 2012 and January 2019 were retrospectively reviewed. Results A total of 59 patients were included. Endoscopic examination showed a normal pars tensa but retraction of the pars flaccida in all patients. No granulation tissue or debris were observed. Low-pitched tinnitus was the principal complaint of 55 patients (100 per cent), followed by ear fullness (14 patients, 23.7 per cent). Of the 59 patients, 52 patients (88.1 per cent) underwent canal wall up mastoidectomy and 7 patients (11.9 per cent) underwent endoscopic endaural atticoantrotomy. No ossicular chain destruction was evident. All patients were followed up for 12 months. Tinnitus disappeared completely in 48 patients (81.4 per cent), improved significantly in 9 patients (15.3 per cent) and improved mildly in 2 patients (3.3 per cent). Conclusion A granulation tissue pathology should be considered when a patient complains of low-pitched tinnitus and exhibits retraction of the pars flaccida. Computed tomography and surgical exploration should be scheduled.

scholarly journals Ossicular Involvement and Types of Pathology in Chronic Otitis Media Squamous Active Disease

2018 ◽  
Vol 1 (1) ◽  
pp. 45-48
Author(s):  
Swasti Sharma
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Revision Surgery ◽  
Mixed Type ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Pars Flaccida ◽  
The Status ◽  
Active Disease

Background: Chronic otitis media (COM) squamous type is commonly as­sociated with cholesteatoma. In COM squamous type with active disease, there is retraction of pars flaccida or pars tensa with retention of squamous epithelial debris and is associated with inflammation and production of pus. It is potentially dangerous because it can cause resorption of bone, leading to ossicular erosion and destruction of bony plates of middle ear. The objective of this study is to determine the effect of chronic otitis media squamous type on the ossicular chain as well as to observe the types of pathology in this disease. Methods and materials: Fifty cases of chronic otitis media squa­mous type who underwent surgical management were included. The status of ossicular chain was evaluated intraoperatively. The type of pathology in­volving middle ear was also studied. Cases admitted for revision surgery were excluded from the study. Results: Of the total fifty cases, ossicular changes were observed in forty eight cases and in two cases all ossicles were intact. Long process of incus is the most frequently involved ossicle. The most common pathology was found to be mixed type (52%). Conclusion: The conclusion of this study is that ossicular chain is commonly involved in chronic otitis media squamous type and mixed pathology consisting of cholesteatoma and granulation tissue is the most frequent pathology.

scholarly journals Correlation between functional outcome and the SAMEO-ATO framework

2021 ◽  
Author(s):  
Vito Pontillo ◽  
Marialessia Damiani ◽  
Giusi Graziano ◽  
Nicola Quaranta
Keyword(s):  
Functional Outcome ◽  
Middle Ear ◽  
Petrous Bone ◽  
Canal Wall ◽  
Hearing Results ◽  
Tertiary Referral Center ◽  
Ossicular Reconstruction ◽  
Canal Wall Down ◽  
Mastoid Surgery ◽  
Canal Wall Up

Abstract Purpose To evaluate the recently proposed SAMEO-ATO framework for middle ear and mastoid surgery, by correlating it with the functional outcome in a large cohort of patients operated for middle ear and mastoid cholesteatoma in a tertiary referral center. Methods We retrospectively included all surgeries for middle ear and mastoid cholesteatoma undergone in our Department between January 2009 and December 2014, by excluding revision surgeries, congenital and petrous bone cholesteatoma. All surgeries were classified according to the SAMEO-ATO framework. The post-operative air bone gap (ABG) was calculated and chosen as benchmark parameter for the correlation analysis. Results 282 consecutive surgeries for middle ear and mastoid cholesteatoma were released in the study period on a total of 273 patients, with a mean age of 41.2 years. All patients were followed for an average period of 55.3 months. 54% of patients underwent M2c mastoidectomy (Canal Wall Down, CWD), while the remaining underwent Canal Wall Up (CWU) procedures, being M1b2a mastoidectomy the most common one (33%). Mean pre-operative and post-operative ABGs were 29.2 and 23.5 dB, with a significant improvement (p < 0.0001). ‘Mastoidectomy’ and ‘Ossicular reconstruction’ parameters of SAMEO-ATO showed significant association with postoperative ABG, with smaller residual gaps for the classes Mx and On, and worse hearing results for M3a and Ox. Conclusion Our results show the utility of SAMEO-ATO framework, and in particular of ‘M’ (Mastoidectomy) and ‘O’ (Ossicular reconstruction) parameters, in predicting the hearing outcome.

scholarly journals Middle ear aeration in staged canal wall up tympanoplasty combined with mastoid cortex plasty or bony mastoid obliteration

2016 ◽  
Vol 130 (S3) ◽  
pp. S24-S24
Author(s):  
Masahiro Komori ◽  
Naoaki Yanagihara ◽  
Jun Hyodo ◽  
Yasuyuki Hinohira ◽  
Ryosei Minoda ◽  
...  
Keyword(s):  
Middle Ear ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Canal Wall Up

Ossicular Chain Reconstruction in a Developing Country

2018 ◽  
Vol 127 (5) ◽  
pp. 306-311 ◽  
Author(s):  
Es-Hak Bedri ◽  
Miriam Redleaf
Keyword(s):  
Tympanic Membrane ◽  
Developing Country ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Ossicular Chain ◽  
Single Stage ◽  
Limited Resources ◽  
Closure Rate ◽  
Average Improvement ◽  
Ossicular Chain Reconstruction

Objectives: In Ethiopia, 2-stage operations with middle ear prostheses are economically unfavorable. We hypothesized that single-stage autologous ossiculoplasty results in acceptable tympanic membrane (TM) and hearing improvements in a setting of limited resources. Methods: One hundred eighty-eight patients (197 ears) who underwent 1-stage autologous ossiculoplasty for ossicular dysfunction are presented. All but 14 of these ears also had perforations of the TM. Conditions of the middle ear were granulation tissue, ossicular disruption only, tympanosclerosis, and cholesteatoma. Reconstructions of the ossicular chain were performed with autologous ossicles only. Results: The closure rate of TM perforations was 95%. Preoperative air bone gaps were 27 to 60 dB (mean [SD] = 44 [7] dB); postoperative air bone gaps were 0 to 50 dB (average [SD] = 23 [10] dB), for an average improvement of 21 dB across all reconstruction types ( P < .001). The largest favorable changes in air bone gaps were with incus and malleus columellas from the footplate to the TM (33 and 23 dB, respectively) ( P < .001). No patient had worsening of sensorineural hearing levels or extrusion of the reconstructed ossicles. Conclusion: Autologous ossiculoplasty performed well in this setting. Acceptable TM closure rates and improvement of air bone gaps were seen in 1-stage operations without the use of prostheses.

scholarly journals Management of Benign Middle Ear Tumors: A Series of 7 Cases

2017 ◽  
Vol 96 (10-11) ◽  
pp. 426-432
Author(s):  
Z. Jason Qian ◽  
Amy M. Coffey ◽  
Kathleen M. O'Toole ◽  
Anil K. Lalwani
Keyword(s):  
Surgical Management ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Clinical Findings ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tumor Excision ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Rare Group

Benign middle ear tumors represent a rare group of neoplasms that vary widely in their pathology, anatomy, and clinical findings. These factors have made it difficult to establish guidelines for the resection of such tumors. Here we present 7 unique cases of these rare and diverse tumors and draw from our experience to recommend optimal surgical management. Based on our experience, a postauricular incision is necessary in nearly all cases. Mastoidectomy is required for tumors that extend into the mastoid cavity. Whenever exposure or hemostasis is believed to be inadequate with simple mastoidectomy, canal-wall-down mastoidectomy should be performed. Finally, disarticulation of the ossicular chain greatly facilitates tumor excision and should be performed early in the procedure.

scholarly journals Canal wall down versus canal wall up surgeries in the treatment of middle ear cholesteatoma

2019 ◽  
Vol 49 (5) ◽  
pp. 1426-1432
Author(s):  
Recep KARAMERT ◽  
Fakih Cihat ERAVCI ◽  
Süleyman CEBECİ ◽  
Mehmet DÜZLÜ ◽  
Mehmet Ekrem ZORLU ◽  
...  
Keyword(s):  
Middle Ear ◽  
Canal Wall ◽  
Middle Ear Cholesteatoma ◽  
Canal Wall Down ◽  
Canal Wall Up

Long-term follow up after bony mastoid and epitympanic obliteration: radiological findings

2009 ◽  
Vol 124 (1) ◽  
pp. 37-43 ◽  
Author(s):  
J-P Vercruysse ◽  
B De Foer ◽  
T Somers ◽  
J Casselman ◽  
E Offeciers
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Canal Wall ◽  
Resonance Imaging ◽  
High Resolution Computed Tomography ◽  
Long Term Follow Up ◽  
Echo Planar ◽  
Canal Wall Up

AbstractObjective:The canal wall up bony obliteration technique lowers the incidence of recurrent cholesteatoma, but carries the potential risk of obliterating residual cholesteatoma. The objective of this study was to report long-term follow-up radiological findings after performing a canal wall up bony obliteration technique procedure, in order to detect residual and/or recurrent cholesteatoma.Patients:Fifty-one patients presenting with a cholesteatoma or a troublesome cavity were operated upon using the canal wall up bony obliteration technique, and were evaluated by follow-up imaging a mean of 76.4 months post-operatively (range, 53.8–113.6 months).Intervention:All patients were evaluated with high resolution computed tomography and magnetic resonance imaging (including delayed contrast, T1-weighted imaging and non-echo-planar, diffusion-weighted imaging).Results:Imaging revealed the presence of one residual, one recurrent and one congenital petrosal apex cholesteatoma. On high resolution computed tomography, completely obliterated mastoid filled with bone was observed in 74.5 per cent (38/51) of patients, and an aerated middle-ear cavity in 64.7 per cent (33/51). High resolution computed tomography clearly detected any associated soft tissue present in the middle-ear cavity (18/51) and in the obliterated mastoids (13/51), but could not characterise this tissue. Non-echo-planar, diffusion-weighted magnetic resonance imaging clearly identified all three cholesteatomas, and differentiated them from other associated soft tissues. No cholesteatoma was found within the obliterated mastoids.Conclusion:Long-term follow up indicated that the canal wall up bony obliteration technique is a safe method with which to treat primary and recurrent cholesteatoma and to reconstruct unstable cavities. Soft tissue was found quite often in the middle ear and obliterated mastoids. High resolution computed tomography identified its presence but could not further characterise it. However, non-echo-planar, diffusion-weighted magnetic resonance imaging succeeded in differentiating soft tissues, enabling detection of residual or recurrent cholesteatoma after a canal wall up bony obliteration technique procedure.

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