Bilateral congenital cholesteatoma: Surgical treatment and considerations
| Autor: | Mauricio Gonzalez-Navarro, Adrian L. James, Alessia Rubini, Matteo Alicandri-Ciufelli, Daniele Marchioni, Livio Presutti |
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| Přispěvatelé: | Marchioni D., Rubini A., Gonzalez-Navarro M., Alicandri-Ciufelli M., James A., Presutti L. |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Endoscope medicine.medical_treatment Endoscopic ear surgery Middle Hospitals University 0302 clinical medicine Bilateral congenital cholesteatoma Postoperative Complications Medicine Chronic otits media Middle ear Canada Child Child Preschool Cholesteatoma Cholesteatoma Middle Ear Ear Middle Endoscopy Female Follow-Up Studies Hearing Tests Humans Mastoid Retrospective Studies Treatment Outcome Tympanoplasty 030223 otorhinolaryngology medicine.diagnostic_test Ear General Medicine Hospitals medicine.anatomical_structure 030220 oncology & carcinogenesis medicine.medical_specialty 03 medical and health sciences otorhinolaryngologic diseases Preschool University business.industry Middle Ear Retrospective cohort study medicine.disease Surgery Otorhinolaryngology Pediatrics Perinatology and Child Health business Otorhinolaryngology2734 Pathology and Forensic Medicine |
| Popis: | Objectives To describe a multicenter study regarding surgical management of bilateral congenital cholesteatoma (BCC) and underline the importance of endoscopes in the management of this condition. In BCC, hearing preservation is more crucial than in unilateral cases. The endoscopic approach allows complete removal of cholesteatoma via a minimally invasive technique offering low residual disease rates while preserving the normal physiology of the middle ear and possibly the ossicular chain. Study design Retrospective chart and surgical video review of patients with BCC who underwent surgery at Otolaryngology Department of Modena and Verona University Hospitals and the Hospital for Sick Children, Toronto. Methods From 2002 to November 2016, six patients were identified with bilateral congenital cholesteatoma and included in this study. Pre-operative assessments, surgical treatments and outcomes were collected and described. Results The median age at presentation was 4 years (range 2–7 years). A microscopic post auricular tympanoplasty was performed in two ears, four underwent a canal wall up mastoidectomy procedure and in the other six a transcanal endoscopic approach (TEA) was used. No intra- or post-operative complications were observed in any patients. The mean follow up period was 54.5 months. Conclusions When both ears are involved with congenital cholesteatoma, it is particularly important to use a minimally invasive technique that preserves normal ossicular and mastoid structure and function whenever possible. In many cases this can be achieved with TEA, even in young children. In addition the endoscope allows good surgical control of cholesteatoma removal from hidden recesses. |
| Databáze: | OpenAIRE |
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