Primary middle ear inverted papilloma – a case report

2021 ◽  
Vol 70 (4) ◽  
pp. 239-242
Author(s):  
Kryštof Vitoul ◽  
Richard Salzman ◽  
Jana Janková
Keyword(s):  
Case Report ◽  
Otitis Media ◽  
Histological Examination ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Inverted Papilloma ◽  
Radical Mastoidectomy ◽  
Canal Wall Down ◽  
Disease Free

Inverted papilloma is a very rare finding in the middle ear. It is a benign, though locally aggressive tumour with a tendency towards malignant transformation. The dia­gnosis is usually established postoperatively, based on the histological examination, because the local finding is not specific and resembles chronically inflamed tissue in chronic otitis media. Surgery is the treatment of choice. Radiotherapy is reserved for inoperable tumours or a recurrent disease. In this case report, we present a case of a 62-year-old man, who underwent canal wall down tympanoplasty for chronic otitis media in a district hospital many years ago. A few years ago he was examined for pulsatile tinnitus and hearing impairment at our clinic. A combined-approach tympanoplasty did not reveal the expected tumour (only stiff scars) and a clearance of the middle ear cavity was performed. Histological examination revealed an inverted papilloma. A CT scan performed postoperatively proved a tumour persistence. Therefore, a radical mastoidectomy was indicated. The patient is disease-free with no signs of recurrence during 32-month follow-up. Keywords: inverted papilloma – Middle ear – radical mastoidectomy

S224 – Efficacy of Long Silastic Sheet in COM Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P150-P150
Author(s):  
Hyong-Ho Cho ◽  
Hyun-Seok Choi ◽  
Chul-Ho Jang ◽  
Yong-Bum Cho
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Valsalva Maneuver ◽  
Chronic Otitis Media ◽  
Mastoid Cavity ◽  
Middle Ear Mucosa ◽  
Hearing Result ◽  
Staged Operation ◽  
Canal Wall Up

Objectives To determine the effect of long silastic sheet for middle ear aeration in chronic otitis media surgery. Methods Between January 2003 and May 2007, 46 patients underwent planned staged canal wall up tympanomastoidetomy, because possibility of residual cholesteatoma and severe swelling middle ear mucosa, especially around the stapes. Long silastic sheet was inserted from mastoid cavity to middle ear via facial recess during operation procedure. To determine the effect of long silastic sheet for recovery of mastoid aeration, various factors such as computed tomography grading, Valsalva maneuver grading for Eustachian function, and hearing result were compared. Results During the average follow-up of 31 months, there was 1 recurred chronic otitis media which was revealed tuberculosis otitis media. Intact tympanic membrane was obtained in 45(97.8%) of 46 patients. In CT grading, middle ear aeration was increased significantly (p<0.05). Air-Bone gap was significantly decreased after staged operation, preoperative average ABG was 29.7dB and last average ABG was 21.0dB (p <0.05). But Eustachian function using Valsalva manerver was not significantly changed (p >0.05). Conclusions Long silastic sheet insertion from mastoid to middle ear is statistically effective for amelioration of middle ear and mastoid aeration after the first-stage operation.

Atypical incus necrosis: a case report and literature review

2007 ◽  
Vol 122 (10) ◽  
pp. 1124-1126 ◽  
Author(s):  
N Choudhury ◽  
G Kumar ◽  
M Krishnan ◽  
D J Gatland
Keyword(s):  
Case Report ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Conductive Deafness ◽  
Ossicular Replacement ◽  
Stapes Footplate ◽  
History Of ◽  
Serous Otitis Media ◽  
Replacement Prosthesis

AbstractObjective:We report an atypical case of ossicular necrosis affecting the incus, in the absence of any history of chronic serous otitis media. We also discuss the current theories of incus necrosis.Case report:A male patient presented with a history of right unilateral hearing loss and tinnitus. Audiometry confirmed right conductive deafness; tympanometry was normal bilaterally. He underwent a right exploratory tympanotomy, which revealed atypical erosion of the proximal long process of the incus. Middle-ear examination was otherwise normal, with a mobile stapes footplate. The redundant long process of the incus was excised and a partial ossicular replacement prosthesis was inserted, resulting in improved hearing.Conclusion:Ossicular pathologies most commonly affect the incus. The commonest defect is an absent lenticular and distal long process of the incus, which is most commonly associated with chronic otitis media. This is the first reported case of ossicular necrosis, particularly of the proximal long process of the incus, in the absence of chronic middle-ear pathology.

Posterior meatal wall reconstruction in tympanoplasty

1981 ◽  
Vol 95 (9) ◽  
pp. 893-898 ◽  
Author(s):  
P. Vase ◽  
B. I. Larsen ◽  
B. Walter
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Operative Method ◽  
Field Of Vision

SummaryAn operative method is described which has been employed in 41 cases of severe chronic otitis media. The posterior meatal wall was removed and reconstructed during the same operation, following cleansing of the middle-ear cavity and ossiculoplasty. Either autograft bone (previously removed from the meatal wall) or homograft cartilage was employed for the reconstruction. All the ears were found to be dry at the follow-up examination after an average or 28 months, but 18 per cent had reccurrence of the cholesteatoma. A SRT improvement of 5–30 db. was observed in 78 per cent, and in 21 per cent a deterioration of between 0 and 10 db. The method provides a good field of vision of the middle-ear cavity and in no cases was rejection of the re-implanted material observed.

Revision surgery for chronic otitis media: recurrent-residual disease and hearing

2002 ◽  
Vol 116 (12) ◽  
pp. 996-1000 ◽  
Author(s):  
Stephen O’Leary ◽  
Jan E. Veldman
Keyword(s):  
Retrospective Analysis ◽  
Otitis Media ◽  
Surgical Approach ◽  
Revision Surgery ◽  
Residual Disease ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Persistent Disease ◽  
Canal Wall Down

The aim of this study was to determine the effect of surgical approach, intact canal wall (ICW) or canal wall down (CWD), upon the success of revision surgery for chronicotitis media (COM). A retrospective analysis of 367 patients (including 65 children aged <15years) who underwent revision tympanoplasty because of persistent disease was performed. Single-staged tympanoplasty was performed, preserving the canal wall when present. Hearing was reconstructed with allograft incus. Follow-up ranged from one to 15 years. Hearing was determined by pre- and post-operative air-bone gaps.Post-operative re-perforation, aural discharge and/or cholesteatoma rates were similar for CWD and ICW. Cholesteatoma could present following the revision, even though it was not apparentat surgery. Following tympanoplasty, the final hearing was not significantly affected by the surgical approach or presence of cholesteatoma. Improvement in hearing was adversely affected by cholesteatoma or an absent stapes suprastructure.Revision ICW and CWD operations were both successful in controlling signs of COM. Cholesteatoma is a peripheral risk in COM and may become apparent after revision surgery.

Tympanic Membrane Perforations and Tympanostomy Tubes

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 27-30 ◽  
Author(s):  
Sam Levine ◽  
Kathleen Daly ◽  
G. Scott Giebink
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforations ◽  
Tympanostomy Tubes ◽  
Preoperative Factor ◽  
Middle Ear Disease

Tympanoplasty and tympanostomy tubes were developed at the same time and have dramatically changed the treatment of chronic middle ear disease. One hundred forty-nine children who had tubes inserted between ages 6 months and 8 years for chronic otitis media with effusion have been prospectively followed up for an average of 4 years. Fourteen percent developed tympanic membrane perforations. No preoperative factor completely predicted the development of perforation. a majority of the perforations closed spontaneously. Three ears had noncontiguous observations of perforations during follow-up. The implications of these findings are discussed with respect to tympanoplasty.

scholarly journals Relation between Ossicular Erosion and Destruction of Facial and Lateral Semicircular Canals in Chronic Otitis Media

2016 ◽  
Vol 21 (03) ◽  
pp. 239-242 ◽  
Author(s):  
Suphi Bulğurcu ◽  
İlker Arslan ◽  
Bünyamin Dikilitaş ◽  
İbrahim Çukurova
Keyword(s):  
Facial Nerve ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Semicircular Canals ◽  
Ossicular Chain ◽  
Facial Canal ◽  
Canal Wall ◽  
Radical Mastoidectomy ◽  
Canal Wall Down ◽  
Canal Wall Up

Introduction Chronic otitis media can cause multiple middle ear pathogeneses. The surgeon should be aware of relation between ossicular chain erosion and other destructions because of the possibility of complications. Objective This study aimed to investigate the rates of ossicular erosion in cases of patients with and without facial nerve canal destruction, who had undergone mastoidectomy due to chronic otitis media with or without cholesteatoma. Methods We retrospectively analyzed three hundred twenty-seven patients who had undergone tympanomastoidectomy between April 2008 and February 2014. We documented the types of mastoidectomy (canal wall up, canal wall down, and radical mastoidectomy), erosion of the malleus, incus and stapes, and the destruction of facial and lateral semi-circular canal. Results Out of the 327 patients, 147 were women (44.95%) and 180 were men (55.04%) with a mean age 50.8 ± 13 years (range 8–72 years). 245 of the 327 patients (75.22%) had been operated with the diagnosis of chronic otitis media with cholesteatoma. FNCD was present in 62 of the 327 patients (18.96%) and 49 of these 62 (79.03%) patients had chronic otitis media with cholesteatoma. The correlation between the presence of FNCD with LSCC destruction and stapes erosion in chronic otitis media with cholesteatoma is statistically significant (p < 0.05). Conclusion Although incus is the most common of destructed ossicles in chronic otitis media, facial canal destruction is more closely related to stapes erosion.

scholarly journals Functional outcomes of middle ear cholesteatoma surgery

2018 ◽  
Vol 71 (3-4) ◽  
pp. 109-113
Author(s):  
Dalibor Vranjes ◽  
Sanja Spiric ◽  
Slobodan Spremo ◽  
Dmitar Travar ◽  
Predrag Spiric ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Lower Incidence ◽  
Functional Outcomes ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Canal Wall Down ◽  
Canal Wall Up

Introduction. Chronic otitis media is defined as a persistent inflammation of the middle ear with signs of an infection lasting for three months or longer. Chronic otitis media may occur either with or without cholesteatoma. For both types of conditions, surgical treatment with closed canal wall-up or open canal wall-down techniques of tympanoplasty are considered. Our aim was to evaluate functional outcomes in two groups of patients (chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma) treated with various tympanoplasty techniques. Material and Methods. This retrospective study included 100 patients who underwent canal wall-down and canal wall-up tympanoplasty for the treatment of chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma from 2015 to 2016. All study patients underwent routine clinical and audiometric examinations. The study evaluated preoperative and postoperative functional results (evaluation of pure-tone audiogram screening). Results. A statistically significant lower incidence (p < 0.05) of postoperative air-bone gap < 20 decibels was established in patients with chronic otitis media with cholesteatoma, but there were no statistically significant differences between the two groups. There was a statistically lower incidence (p < 0.05) of patients with postoperative pure tone audiometry < 40 decibels in patients with chronic otitis media with cholesteatoma, but the difference between the two groups was not statistically significant. When analyzing the mean postoperative pure tone audiometry and air-bone gap in the study patients, canal wall-up tympanoplasty was found to be statistically more effective (p < 0.05). Conclusion. Various pathomorphological and pathophysiological changes in the middle ear, presence of extensively different forms of cholesteatomas, the choice of surgical procedures and poor preoperative hearing are in direct correlation with postoperative hearing.

Surgical Advances in Treating Otitis Media

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 49-53 ◽  
Author(s):  
Michael M. Paparella ◽  
Oleg Froymovich
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Combined Approach ◽  
Radical Mastoidectomy ◽  
Closed Cavity ◽  
Surgical Methods ◽  
Ventilation Tubes

Surgical methods of treating otitis media and its sequelae are discussed, according to the classification of otitis media presented in an earlier report Surgical management of otitis media with effusion and recurrent purulent otitis media includes myringotomy and use of ventilation tubes. Occasionally, otitis media with effusion will lead to structural and other pathologic changes in the middle ear, and conservative treatments such as use of medication or tubes will not suffice. Indications and methods for exploratory tympanotomy and reconstruction of the middle ear are discussed. In such instances, tympanoplasty can be used to the patient's benefit Chronic otitis media with mastoiditis, defined by the presence of intractable pathologic tissue, generally requires surgical correction. Classic methods include simple mastoidectomy, modified radical (Bondy) mastoidectomy, and radical mastoidectomy. Current classifications of procedures would also include closed-cavity tympanomastoidectomy, open-cavity tympanomastoidectomy, and intact-bridge tyrnpanomastoidectomy (a combined approach). The diagnostic and surgical approach to silent or subclinical otitis media is discussed. Diagnosis and treatment of sequelae of otitis media, including sequelae in the middle ear and, less commonly, in the inner ear, are discussed.

Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

2019 ◽  
Vol 15 (10) ◽  
pp. 990-993 ◽  
Author(s):  
Elif Gündoğdu ◽  
Uğur Toprak
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Middle Ear ◽  
Healthy Subjects ◽  
Normal Values ◽  
Chronic Otitis Media ◽  
Healthy Individuals ◽  
Inner Diameter ◽  
Male Patients ◽  
The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

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