A case series of cholesteatoma spread in middle ear cleft
Keywords:Middle ear cleft, Cholesteatoma, Mastoid exploratory surgery
Background: This study aimed to describe the spread of cholesteatoma in middle ear cleft.
Methods: The 20 patients diagnosed with chronic otitis media, squamosal type (cholesteatoma) who underwent mastoidectomy exploration were included in this study. The main emphasis was to find out the extent and spread of cholesteatoma into the middle ear cleft.
Results: The result of the study showed 50% of cases spread to middle ear cavity (20% -meso tympanum, 15%-sinus tympani,15%-facial recess), 20% into the attic, 30% into adits, antrum and mastoid air cell system.
Conclusions: All of our patients underwent mastoid exploratory surgery. In half of the cases, the cholesteatoma was restricted to middle ear cavity, while in remaining 50% it has extended to attic, aditus mastoid antrum and mastoid air cells. Disease clearance was effective with no post-operative complication or recurrence in first 50% cases. Other 50% of cases required extensive surgery for disease clearance.
Law KP, Smyth GD, Kerr AG. Fistulae of the labyrinth treated by staged combined approach tympanoplasty. J Laryngol Otol. 1975;89(5):471-8.
Nevoux J, Lenoir M, Roger G, Denoyelle F, Le Pointe HD, Garabédian EN. Childhood cholesteatoma. Eur Ann Otorhinolaryngol Head Neck Dis. 2010;127(4):143-50.
Semaan MT, Megerian CA. The pathophysiology of cholesteatoma. Otolaryngol Clin N Am. 2006;39(6):1143-59.
Swartz JD, Varghese S. Parsflaccidacholesteatoma as demonstrated by computed tomography. Arch Otolaryngol. 1984;110(8):515-7.
Sade J, Berco E, Buyanover D, Brown M. Ossicular damage in chronic middle ear inflammation. Acta Oto-Laryngologica. 1981;92(1-6):273-83.
Goycoolea MV, Hueb MM, Muchow D, Paparella MM. The theory of the trigger, the bridge and the transmigration in the pathogenesis of acquired cholesteatoma. Actaotolaryngologica. 1999;119(2):244-8.
Gulati M, Gupta S, Prakash A, Garg A, Dixit R. HRCT imaging of acquired cholesteatoma: a pictorial review. Insights into imaging. 2019;10(1):1-8.
Chee NW, Tan TY. The value of pre-operative high resolution CT scans in cholesteatoma surgery. Singapore Med J. 2001;42(4):155-9.
Mafee MF. MRI and CT in the evaluation of acquired and congenital cholesteatomas of the temporal bone. J Otolaryngol. 1993;22(4):239-48.