Intact Canal Wall Mastoidectomy Combined with Balloon Dilation Eustachian Tuboplasty in the Treatment of Middle Ear Cholesterol Granuloma

Background. Cholesterol granuloma of the middle ear is extremely rare in comparison to cholesterol granuloma of the petrous apex but sometimes shows an aggressive course.Case Report. We report herein a case involving a large, aggressive cholesterol granuloma of the middle ear that eroded the middle cranial fossa. A 64-year-old woman presented with pain in the left ear and hearing loss. Cholesterol granuloma was finally diagnosed from diffusion-weighted imaging, and cortical mastoidectomy was performed with canal wall down tympanoplasty type III. Recovery was uneventful recovery and the patient well at the 3-year follow-up.Conclusion. This case demonstrates the rare but clinically important pathology of aggressive cholesterol granuloma of the middle ear.

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Effect of Mastoid Cavity Modification on Middle Ear Sound Transmission

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948209100512 ◽

1982 ◽

Vol 91 (5) ◽

pp. 526-532 ◽

Cited By ~ 21

Author(s):

John T. McElveen ◽

Chris Miller ◽

Richard L. Goode ◽

Stephen A. Falk

Keyword(s):

Middle Ear ◽

Computer Model ◽

Sound Transmission ◽

Mastoid Cavity ◽

Canal Wall ◽

Radical Mastoidectomy ◽

Analog Model ◽

Modified Radical Mastoidectomy ◽

Temporal Bones ◽

Intact Canal Wall Mastoidectomy

The modified radical mastoidectomy and intact canal wall mastoidectomy are the two most popular procedures used today for the treatment of chronic middle ear and mastoid disease. Their effects on the anatomy of the middle ear and mastoid cavity are quite different and it might also be expected that they would modify middle ear sound transmission in different ways. This paper describes experiments with human temporal bones and a middle ear computer analog model that attempt to define acoustic differences produced by cavity modifications in these two procedures. The temporal bone studies showed that blocking the aditus (as in modified radical mastoidectomy) produced improved sound transmission in the 1,500- to 4,000-Hz range and decreased transmission below 1,000 Hz when compared to the enlarged aditus and enlarged mastoid condition (as in intact canal wall mastoidectomy). The computer model showed better transmission at all frequencies with the intact canal wall mastoidectomy simulation.

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Outcome of intact canal wall mastoidectomy in limited attic cholesteatoma

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20172584 ◽

2017 ◽

Vol 3 (3) ◽

pp. 596

Author(s):

Rajeev Reddy

Keyword(s):

Patient Compliance ◽

Middle Ear ◽

Revision Surgery ◽

Reliable Method ◽

Operating Table ◽

Canal Wall ◽

Second Stage ◽

Intact Canal Wall Mastoidectomy ◽

Canal Wall Up ◽

Selection Of

Background: Surgery for cholesteatoma has evolved over the years in terms of efficacy and patient compliance and better life. Intact canal wall technique is best in terms of normalization of the physiology of the ear along with eradication of disease. Hence this study is undertaken to evaluate a technique of intact canal wall mastoidectomy for limited attic cholesteatoma and to study practical considerations during surgery.Methods: Any person undergoing surgery for attic cholesteatoma has to be thoroughly examined during surgery and decision for doing a canal wall up (CWP) surgery will be taken on the operating table. The patients were regularly followed up and microscopic, otoendoscopic and audiological assessments done at regular intervals. Revision surgery was done only if there were signs of recidivism or if ossiculoplasty was planned for second stage or placement of prosthesis later was considered. Results: Out of 100 cholesteatoma surgeries, 22 cases found suitable for the CWU technique. Only 1 out of 22 patients required revision surgery due to recurrence. Rest of the patients maintained healthy middle ear for more than a year. Prevention of medialization of attic cartilage piece was found to be a very important consideration.Conclusions: The CWU technique is a reliable method of management for limited attic cholesteatoma. Selection of subjects should be very meticulous.

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The use of rigid endoscopes in cholesteatoma surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215100126611 ◽

1994 ◽

Vol 108 (4) ◽

pp. 307-309 ◽

Cited By ~ 24

Author(s):

Matthew Man Wah Yung

Keyword(s):

Middle Ear ◽

Complete Removal ◽

Open Cavity ◽

Operating Microscope ◽

Canal Wall ◽

Small Cavity ◽

Mastoid Operation ◽

Canal Wall Reconstruction ◽

Cholesteatoma Surgery

AbstractThe existence of blind pockets in the middle ear during cholesteatoma surgery could compromise complete removal of the disease, e.g. from the sinus tympanum. The use of side-viewing rigid endoscopes in conjunction with the operating microscope to control and facilitate cholesteatoma removal during mastoid operation studied.Ninety-two primary operations for cholesteatoma over a four-year period were examined. Over one-third (35.9 per cent) of these cases had cholesteatoma extended into the sinus tympanum. Sixty-four operations were small cavity mastoidectomy. The others were either canal wall reconstruction or primary obliteration following open cavity mastoidectomy.Although residual cholesteatoma was found in three patients, only one was in the middle ear. It is concluded from this study that side-viewing endoscopes could be very useful in cholesteatoma surgery.

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Correlation between functional outcome and the SAMEO-ATO framework

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-07000-3 ◽

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.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215116001961 ◽

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

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A rare case of bilateral congenital posterior mesotympanic cholesteatoma

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v17i2.35891 ◽

2018 ◽

Vol 17 (2) ◽

pp. 307-310

Author(s):

Ahmad Hafiz Ali ◽

Zulkiflee Salahuddin ◽

Mohd Khairi MD Daud ◽

Rosdan Salim

Keyword(s):

Soft Tissue ◽

Tympanic Membrane ◽

Middle Ear ◽

Rare Case ◽

Medical Science ◽

Canal Wall ◽

Common Site ◽

Congenital Cholesteatoma ◽

Canal Wall Down ◽

The Common

Bilateral congenital mesotympanic cholesteatoma is a very rare disease. It can present differently from ordinary congenital cholesteatoma. We report a case of bilateral congenital cholesteatoma diagnosed at age of 22 years old. She presented with bilateral intermittent ear discharge since 10 years old that worsening two weeks prior to her presentation to our clinic and associated with bilateral reduced hearing. Clinically there was intact tympanic membrane with retraction of the mesotympanic area with present of mass medial to tympanic membrane. CT scan imaging showed there was soft tissue in the bilateral middle ear cavity with intact scutum and ossicles. Patient undergone canal wall down procedure and the diagnosis of congenital mesotympanic cholesteatoma was confirmed with present of cholesteatoma sac at the posterosuperior part, as opposed to anterosuperior quadrant, where the common site for congenital cholesteatoma.Bangladesh Journal of Medical Science Vol.17(2) 2018 p.307-310

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

Ear Nose & Throat Journal ◽

10.1177/0145561317096010-1122 ◽

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.

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Regenerated Middle Ear Mucosa after Tympanoplasty. Part I. Transmission Electron Microscopy

Otolaryngology ◽

10.1177/019459988609400314 ◽

1986 ◽

Vol 94 (3) ◽

pp. 339-343 ◽

Cited By ~ 4

Author(s):

Roberto Gamoletti ◽

Paola Poggi ◽

Mario Sanna ◽

Carlo Zini

Keyword(s):

Electron Microscopy ◽

Middle Ear ◽

Goblet Cells ◽

Secretory Cells ◽

Canal Wall ◽

Ciliated Cells ◽

Middle Ear Mucosa ◽

Morphologic Characteristics ◽

Transmission Electron ◽

Ultrastructural Appearance

The ultrastructural appearance of the regenerated middle ear mucosa—found at the second operation of staged intact canal wall tympanoplasty (ICWT) with mastoidectomy—has been evaluated with the transmission electron microscope. The regenerated epithelium showed all the morphologic characteristics of the normal middle ear mucosa: ciliated cells, noncillated cells, and secretory cells. All of these (Including goblet cells) have been found in the specimens. It is concluded that a normal middle ear mucosa regenerates to cover all denuded bone surfaces after the first operation of staged ICWT with mastoidectomy, when silicone rubber sheeting has been used to prevent adhesions and maintain an air-containing middle ear space.

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Glomus tympanicum chemodectoma: unusual radiological findings

The Journal of Laryngology & Otology ◽

10.1017/s0022215100127586 ◽

1994 ◽

Vol 108 (7) ◽

pp. 607-609 ◽

Cited By ~ 4

Author(s):

Abduljabbar Alshaikhly ◽

Abdalla M. Hamid ◽

Bahram Azadeh

Keyword(s):

Middle Ear ◽

Malignant Tumour ◽

Canal Wall ◽

Ear Canal ◽

Radiological Findings ◽

Glomus Tympanicum ◽

History Of ◽

One Year ◽

The Right ◽

Temporal Bones

AbstractA 64-year-old Qatari female, with a one-year history of right otorrhoea and deafness, had a reddish-white mass projecting into the right ear canal, through the tympanic membrane, that proved histopathologically to be a paraganglioma. Computerized tomography (CT) of the temporal bones showed extensive destruction of the right mastoid bone, the posterior ear canal wall, and the sinus plate, with total disruption of the ossicles, simulating a malignant tumour, which is unusual for a middle ear paraganglioma.

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