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Kubota T, Ito T, Furukawa T, Matsui H, Goto T, Shinkawa C, Matsuda H, Ikezono T, Kakehata S. Clinical course of five patients definitively diagnosed with idiopathic perilymphatic fistula treated with transcanal endoscopic ear surgery. Front Neurol 2024; 15:1376949. [PMID: 38560729 PMCID: PMC10978713 DOI: 10.3389/fneur.2024.1376949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
Objectives An idiopathic perilymphatic fistula (PLF) can be difficult to diagnose because patients present with sudden sensorineural hearing loss (SSHL) and/or vestibular symptoms without any preceding events. In such cases, we currently test for cochlin-tomoprotein (CTP) to confirm the diagnosis of idiopathic PLF because CTP is only detected in the perilymph. In this study, we report the clinical course of five patients definitively diagnosed with idiopathic PLF who underwent PLF repair surgery using transcanal endoscopic ear surgery (TEES). Patients and methods Five patients were initially treated with intratympanic dexamethasone for SSHL, at which time a CTP test was also performed (preoperative CTP test). Due to refractory hearing loss and/or fluctuating disequilibrium, PLF repair surgery using TEES was performed to seal the oval and round windows using connective tissue and fibrin glue. These patients were diagnosed with definite idiopathic PLF based on pre- or intra-operative CTP test results (negative, < 0.4 ng/mL; intermediate, 0.4-< 0.8 ng/mL; and positive, > 0.8 ng/mL). We evaluated pre- and intra-operative CTP values, intraoperative surgical findings via a magnified endoscopic view, and pre- and post-operative changes in averaged hearing level and vestibular symptoms. Results Pre- and intra-operative CTP values were positive and intermediate in three patients, positive and negative in one patient, and negative and positive in one patient. None of the patients had intraoperative findings consistent with a fistula between the inner and middle ears or leakage of perilymph. Only two patients showed a slight postoperative recovery in hearing. Four patients complained of disequilibrium preoperatively, of whom two had resolution of disequilibrium postoperatively. Conclusion A positive CTP test confirms PLF in patients without obvious intraoperative findings. The CTP test is considered more sensitive than endoscopic fistula confirmation. We consider that CTP test results are important indicators to decide the surgical indication for idiopathic PLF repair surgery. In our experience with the five cases, two of them showed improvements in both hearing and vestibular symptoms.
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Affiliation(s)
- Toshinori Kubota
- Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
- Department of Otolaryngology, Yonoezawa City Hospital, Yonezawa, Yamagata, Japan
| | - Tsukasa Ito
- Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Takatoshi Furukawa
- Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
- Department of Otolaryngology, Yamagata Prefectural Shinjyo Hospital, Shinjo, Yamagata, Japan
| | - Hirooki Matsui
- Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Takanari Goto
- Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Chikako Shinkawa
- Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
| | - Han Matsuda
- Department of Otolaryngology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Tetsuo Ikezono
- Department of Otolaryngology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Seiji Kakehata
- Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan
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Kadowaki Y, Ide S, Nakamura T, Okuda T, Shigemi H, Hirano T, Takahashi K, Suzuki M. Epidemiology of Congenital Cholesteatoma: Surveys of the Last 17 Years in Japan. J Clin Med 2024; 13:1276. [PMID: 38592124 PMCID: PMC10931836 DOI: 10.3390/jcm13051276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 02/21/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: The incidence of congenital cholesteatoma (CC) has rarely been discussed, particularly from a demographic viewpoint. Therefore, we conducted an epidemiological study of CC using local medical characteristics. (2) Methods: The participants were 100 patients (101 ears) who underwent initial surgical treatment at university hospitals in two rural prefectures between 2006 and 2022. A total of 68% of the patients were males and 32% were females, with a median age of 5 years. We reviewed the medical records for the date of birth, date of surgery, stage of disease, and first symptoms of the disease. (3) Results: The total incidence of CC was calculated to be 26.44 per 100,000 births and tended to increase. No significant difference was found between the incidences in the two prefectures. The number of surgeries performed was higher in the second half of the study period. No difference in the stage of progress was observed based on age. (4) Conclusions: The incidence of CC was estimated to be 26.44 per 100,000 newborn births. The number of patients with CC tended to increase; however, this can be attributed to an increase in the detection rate rather than the incidence.
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Affiliation(s)
- Yoshinori Kadowaki
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Oita University, Oita 879-5593, Japan; (Y.K.); (H.S.); (M.S.)
| | - Shinsuke Ide
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Miyazaki University, Miyazaki 889-1601, Japan; (S.I.); (T.N.); (K.T.)
| | - Takeshi Nakamura
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Miyazaki University, Miyazaki 889-1601, Japan; (S.I.); (T.N.); (K.T.)
| | - Takumi Okuda
- Department of Otolaryngology-Head and Neck Surgery, Miyazaki Prefectural Miyazaki Hospital, Miyazaki 880-0017, Japan;
| | - Hideto Shigemi
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Oita University, Oita 879-5593, Japan; (Y.K.); (H.S.); (M.S.)
| | - Takashi Hirano
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Oita University, Oita 879-5593, Japan; (Y.K.); (H.S.); (M.S.)
| | - Kuniyuki Takahashi
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Miyazaki University, Miyazaki 889-1601, Japan; (S.I.); (T.N.); (K.T.)
| | - Masashi Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Oita University, Oita 879-5593, Japan; (Y.K.); (H.S.); (M.S.)
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Cao C, Song J, Su R, Wu X, Wang Z, Hou M. Structure-constrained deep feature fusion for chronic otitis media and cholesteatoma identification. MULTIMEDIA TOOLS AND APPLICATIONS 2023:1-21. [PMID: 37362730 PMCID: PMC10157598 DOI: 10.1007/s11042-023-15425-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/19/2023] [Accepted: 04/18/2023] [Indexed: 06/28/2023]
Abstract
Chronic suppurative otitis media (CSOM) and middle ear cholesteatoma (MEC) were two most common chronic middle ear disease(MED) clinically. Accurate differential diagnosis between these two diseases is of high clinical importance given the difference in etiologies, lesion manifestations and treatments. The high-resolution computed tomography (CT) scanning of the temporal bone presents a better view of auditory structures, which is currently regarded as the first-line diagnostic imaging modality in the case of MED. In this paper, we first used a region-of-interest (ROI) network to find the area of the middle ear in the entire temporal bone CT image and segment it to a size of 100*100 pixels. Then, we used a structure-constrained deep feature fusion algorithm to convert different characteristic features of the middle ear in three groups as suppurative otitis media (CSOM), middle ear cholesteatoma (MEC) and normal patches. To fuse structure information, we introduced a graph isomorphism network that implements a feature vector from neighbourhoods and the coordinate distance between vertices. Finally, we construct a classifier named the "otitis media, cholesteatoma and normal identification classifier" (OMCNIC). The experimental results achieved by the graph isomorphism network revealed a 96.36% accuracy in all CSOM and MEC classifications. The experimental results indicate that our structure-constrained deep feature fusion algorithm can quickly and effectively classify CSOM and MEC. It will help otologist in the selection of the most appropriate treatment, and the complications can also be reduced.
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Affiliation(s)
- Cong Cao
- School of Mathematics and Statistics, Central South University, Changsha, 410083 China
| | - Jian Song
- Department of Otorhinolaryngology of Xiangya Hospital, Central South University, Changsha, 410008 China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, 410008 China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, 410008 China
| | - Ri Su
- School of Mathematics and Statistics, Central South University, Changsha, 410083 China
| | - Xuewen Wu
- Department of Otorhinolaryngology of Xiangya Hospital, Central South University, Changsha, 410008 China
- Key Laboratory of Otolaryngology Major Disease Research of Hunan Province, Changsha, 410008 China
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, 410008 China
| | - Zheng Wang
- School of Computer Science, Hunan First Normal University, Changsha, 410205 China
| | - Muzhou Hou
- School of Mathematics and Statistics, Central South University, Changsha, 410083 China
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Wang X, Guo J, Liu W, Chen M, Shao J, Zhang X, Ma N, Li Y, Peng Y, Zhang J. Comparison of the EAONO/JOS, STAMCO and ChOLE cholesteatoma staging systems in the prognostic evaluation of acquired middle ear cholesteatoma in children. Eur Arch Otorhinolaryngol 2022; 279:5583-5590. [PMID: 35554663 DOI: 10.1007/s00405-022-07400-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/11/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To compare the performance of the EAONO/JOS, STAMCO, and ChOLE Cholesteatoma Staging Systems in prognostic evaluation of children acquired middle ear cholesteatoma after primary surgery and identify the other factors that could predict cholesteatoma recidivism. And the correlation between the staging and the recidivism of cholesteatoma after grouping according to operation was evaluated. METHODS A total of 123 ears of 118 patients that underwent surgery for primary cholesteatoma from November 2008 to May 2020 were included in this retrospective study, and then classified and staged according to the EAONO/JOS, STAMCO, and ChOLE cholesteatoma staging system, respectively. Each indicator involved in the system above was analyzed separately to evaluate its prognostic value for cholesteatoma recidivism. RESULTS The type of surgical procedure performed (P = 0.020) was shown to be associated with cholesteatoma recidivism. Cholesteatoma location the supratubal recess (S1) (P = 0.026, HR = 3.614, 95% CI 1.137, 7.945), and the sinus tympani (S2) (P = 0.004, HR = 4.208, 95% CI 1.574, 11.250) were shown to be significantly associated with disease recidivism. When focusing on the CWU operation group, ossicular chain status in STAMCO stage (P = 0.043) and in the ChOLE stage (P = 0.018) were significantly associated with cholesteatoma recidivism. The results had shown no association between the three stages and cholesteatoma recidivism in the CWD and endoscopic surgery groups. CONCLUSIONS Based on our study, the EAONO/JOS, STAMCO, and ChOLE Classifications have limited value in predicting cholesteatoma recidivism, in acquired middle ear cholesteatoma in children. Adding the pathological status of the ossicular chain may be useful for predicting the recidivism of cholesteatoma. Additional validation studies are entailed to definitively assess the clinical utility of these classifications.
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Affiliation(s)
- Xiaoxu Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Rd, Xicheng District, Beijing, 100045, China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China
| | - Jianlin Guo
- Department of Radiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, 100045, China
| | - Wei Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Rd, Xicheng District, Beijing, 100045, China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China
| | - Min Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Rd, Xicheng District, Beijing, 100045, China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China
| | - Jianbo Shao
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Rd, Xicheng District, Beijing, 100045, China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China
| | - Xiao Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Rd, Xicheng District, Beijing, 100045, China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China
| | - Ning Ma
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Rd, Xicheng District, Beijing, 100045, China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China
| | - Yanhong Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Rd, Xicheng District, Beijing, 100045, China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China
| | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, 100045, China.
| | - Jie Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Rd, Xicheng District, Beijing, 100045, China. .,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China.
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5
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Yoshida S, Seki S, Sugiyama T, Kikuchi S, Iino Y. Clinical characteristics of atelectatic eardrums and adhesive otitis media in children. Int J Pediatr Otorhinolaryngol 2022; 159:111188. [PMID: 35653949 DOI: 10.1016/j.ijporl.2022.111188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/26/2022] [Accepted: 05/22/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Atelectatic eardrum and adhesive otitis media in children are related to persistent otitis media with effusion (OME) and eustachian tube dysfunction in infancy. However, the pathogenesis of these diseases is not fully understood, and some cases even progress to pars tensa cholesteatoma. This study analyzed the clinical characteristics of children with atelectatic eardrum and adhesive otitis media to clarify associated causes of and risk factors for progression of these middle ear pathologies in children. PATIENTS AND METHODS This retroactive study included 38 ears of 31 children with atelectatic eardrums (atelectasis group), and 19 ears of 17 children with adhesive otitis media (adhesive OM group). Thirty-two contralateral non-cholesteatoma ears of 32 children with congenital cholesteatoma were also examined as a control group. Participants were aged 15 or younger. Life history (obtained via questionnaire), associated diseases, hearing acuity, aeration and development of the temporal bone were investigated. RESULTS All children in the atelectasis and adhesive OM groups had a history of recurrent acute otitis media (rAOM) and/or OME. The prevalence of perennial allergic rhinitis was 18 cases (58%) in the atelectasis group and 16 cases (94%) in the adhesive OM group. The prevalence of perennial allergic rhinitis was significantly higher in the adhesive OM group compared to the control group (P < 0.01). The development of mastoid air cells, categorized by MC classification, showed MC0 + MC1 (poor pneumatization) in 19 ears (50.0%) with atelectatic eardrums and 12 ears (63.2%) with adhesive OM. Poor pneumatized mastoid was more frequently observed in the ears of the atelectasis and adhesive OM groups compared to the control group (P < 0.01). No significant difference was found in regards to aeration of the middle ear between the two groups; however, aeration was significantly poorer in both groups compared to the control group (P < 0.01). Three characteristics were analyzed using multivariate logistic regression: perennial allergic rhinitis (odds ratio [OR] 4.319, P = 0.013), poor mastoid pneumatization (OR 8.457, P = 0.012), and pars flaccida retraction pocket (OR 20.897, P = 0.006). These characteristics were shown to be significant risk factors for atelectatic eardrums and adhesive OM. In addition, the predisposition to perennial allergic rhinitis was shown to be the most important factor in the progression from atelectatic eardrum to adhesive otitis media (OR 16.615, P = 0.012). CONCLUSION Children with perennial allergic rhinitis, poor development of mastoid air cells, poor aeration of the temporal bone, and with pars flaccida retraction pocket were at an increased risk of developing an atelectatic eardrum and adhesive OM. In particular, perennial allergic rhinitis was shown to be a significant risk factor in the progression from atelectatic eardrum to adhesive otitis media. Allergic inflammation may affect not only the nasal passages but also the eustachian tube, resulting in persistent middle ear dysfunction. Therefore, children with rAOM/OME who have these risk factors should be carefully monitored and treat over time in effort to prevent progression of pathology.
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Affiliation(s)
- Saeko Yoshida
- Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo, 115-0053, Japan.
| | - Saori Seki
- Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo, 115-0053, Japan
| | - Tomonori Sugiyama
- Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo, 115-0053, Japan
| | - Saori Kikuchi
- Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo, 115-0053, Japan
| | - Yukiko Iino
- Department of Otolaryngology / Deafness and Middle Ear Surgicenter, Tokyo Kita Medical Center, 4-17-56, Akabanedai, Kita-ku, Tokyo, 115-0053, Japan
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Nationwide survey of middle ear cholesteatoma surgery cases in Japan: Results from the Japan Otological society registry using the JOS staging and classification system. Auris Nasus Larynx 2020; 48:555-564. [PMID: 32981816 DOI: 10.1016/j.anl.2020.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study was aimed to determine the characteristics of middle ear cholesteatoma and to investigate short-term outcomes regarding the rates of residual and recurrent cholesteatoma and the postoperative hearing results in Japan, via a nationwide survey using staging and classification criteria for middle ear cholesteatoma, as proposed by the Japan Otological Society (JOS). METHODS The first-round survey was conducted in 2016. The target was patients with middle ear cholesteatoma who were surgically treated in Japan between January and December 2015. Medical information on the patients was anonymized. The questionnaire entries were age, sex, cholesteatoma classification and stage, preoperative hearing level, mastoid development, status of the stapes, and surgical method. There were a total of 1,787 registered patients from 74 facilities from all over Japan. The second survey was conducted in January 2018 and received 1,456 responses from 49 facilities in Japan. Of the 1,456 cases, 1,060 were conducted in the postoperative hearing survey and 1,084 in the residual recurrence survey. RESULTS The most common cholesteatoma type was pars flaccida cholesteatoma (63.3%), followed by pars tensa cholesteatoma (13.0%), congenital cholesteatoma (12.9%), and cholesteatoma secondary to chronic tensa perforation (5.6%). Cholesteatoma of uncertain origin accounted for 5.0% (90 cases). Stage II was predominant in pars flaccida and pars tensa cholesteatoma, which frequently involves the mastoid, whereas about half of cases of cholesteatoma secondary to chronic tensa perforation and congenital cholesteatoma were classified as stage I. One hundred fifty-two of 1,084 cases (14.0%) had recurrent cholesteatoma, residual cholesteatoma, or both following first surgeries. The postoperative rates of hearing success rate was 63.3%. CONCLUSION We were able to clarify not only the current epidemiological status of middle ear cholesteatoma but also the current trends of cholesteatoma surgery in Japan. The development of a staging system by the JOS Committee serving an epidemiological database for international or time-dependent comparison. It is possible to use this staging system with reasonable reliability.
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Hao J, Chen M, Liu B, Yang Y, Liu W, Zhang J, Ni X. The Significance of Staging in the Treatment of Congenital Cholesteatoma in Children. EAR, NOSE & THROAT JOURNAL 2020; 100:1125S-1131S. [PMID: 32603216 DOI: 10.1177/0145561320933965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To analyze the clinical characteristics of congenital cholesteatoma (CC), to explore the risk factors related to recurrence of the disease, and to clarify the importance of staging for treatment. METHODS A total of 87 patients were followed up for more than 5 years, who had undergone surgical procedures for CC from September 2010 to January 2017 in Beijing Children's Hospital, Capital Medical University. Patients with CC were identified in accordance with the following Levenson's criteria. The clinical characteristics of CC on different stage and risk factors related to recurrence of the disease were analyzed. RESULTS Canal wall up mastoidectomy and tympanoplasty (n = 45), transcanal endoscopic approach (n = 29), and canal wall down mastoidectomy and tympanoplasty (n = 13) was, respectively, performed depending on cholesteatoma extension. Between 2010 and 2013, 20.93% of patients had stage I-II disease, whereas 61.26% had stage I-II disease from 2014 to 2017. Meanwhile, the proportion with stage III-IV disease decreased from 79.07% to 38.64% between these 2 time periods. The preoperative air conduction threshold in patients with stage I, II, III, and IV was, respectively, 23.36 ± 8.20, 45.40 ± 12.82, 47.49 ± 12.03, and 50.37 ± 11.80 dB. The stage of disease was a significant risk factor regarding recurrence (P = .02). Surgery on patients with stage III-IV disease was performed with the aid of a microscope from 2010 to 2013 and with a microscope and endoscope from 2014 to 2017, which reduced the recurrence rate from 26.92% in the former period to 8.33% in the latter period. CONCLUSION Early detection of CC is crucial regarding the facilitation of minimally invasive surgery and reducing complication and recurrence rates. The stage of the disease is a significant risk factor regarding recurrence. The surgery shows us the possibility of reducing the recurrence rate of CC, which is performed under a microscope and an endoscope.
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Affiliation(s)
- Jinsheng Hao
- National Center for Children's Health, Beijing, People's Republic of China.,Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Min Chen
- National Center for Children's Health, Beijing, People's Republic of China.,Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Bing Liu
- National Center for Children's Health, Beijing, People's Republic of China.,Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yang Yang
- National Center for Children's Health, Beijing, People's Republic of China.,Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wei Liu
- National Center for Children's Health, Beijing, People's Republic of China.,Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jie Zhang
- National Center for Children's Health, Beijing, People's Republic of China.,Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xin Ni
- National Center for Children's Health, Beijing, People's Republic of China.,Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
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8
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Arai Y, Sano D, Takahashi M, Nishimura G, Sakamaki K, Sakuma N, Komatsu M, Oridate N. Sphenoid sinus development in patients with acquired middle ear cholesteatoma. Auris Nasus Larynx 2020; 47:391-400. [DOI: 10.1016/j.anl.2019.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/19/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
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9
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Zhao M, Chen BJ, Zhao WD, Li Y, Du Q, Yu J, Wang XW, Qian XQ, Yuan YS, Yang JM, Chi FL, Ren DD. Concurrent Occurrence of Congenital Ossicular Anomaly and Localized Cholesteatoma: Series of 10 Cases. ORL J Otorhinolaryngol Relat Spec 2020; 82:139-149. [PMID: 32203956 DOI: 10.1159/000506206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/07/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of this study is to describe the clinical features, managements and outcomes of a rare coexistence of congenital ossicular anomaly and localized cholesteatoma. A literature review on these cases and each congenital disorder is also presented. METHODS A retrospective chart review was performed on patients diagnosed with congenital ossicular anomaly with concurrent localized cholesteatoma from 2008 to 2017. Clinical data of these patients were collected. RESULTS A total of 10 patients were identified. All patients presented with unilateral hearing loss. Pure-tone audiometry showed conductive hearing loss in all affected ears with an average air conduction (AC) threshold of 59 dB. High-resolution computed tomography scans of the temporal bone diagnosed ossicular anomaly for 90% (9/10); however, only 50% (5/10) had a diagnosis of localized cholesteatoma. A transcanal exploratory tympanotomy under the microscope was performed to discover whether the localized tiny-sized cholesteatoma around the ossicular chain did not have direct contact with the ossicular chain, which could be diagnosed as congenital cholesteatoma. We removed the localized cholesteatoma and reconstructed the ossicular chain in each patient. All localized cholesteatomas were found in the posterior-superior quadrant of the middle ear. Ossicular chain anomalies were associated with the incus and/or the stapes in all cases. Hearing improvement was achieved in each of the 6 patients who were followed up postoperatively, with an average AC threshold of 35 dB. The clinical features of congenital ossicular anomaly with concurrent congenital cholesteatoma were compared with those of each congenital disorder. The pathogenesis of each condition was also discussed. CONCLUSIONS Congenital ossicular anomaly with concurrent congenital cholesteatoma is rare. It shares similar clinical features with congenital ossicular anomaly occurring alone, therefore awareness should be raised for a possible concurrent congenital cholesteatoma which was easy to miss in the diagnosis (50%) by the radiologist. A patient's hearing level can be improved by removal of the cholesteatoma and reconstruction of the ossicular chain. Localized cholesteatoma does not usually show residuals or recurrence.
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Affiliation(s)
- Meng Zhao
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Bin-Jun Chen
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Wei-Dong Zhao
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Yike Li
- Department of Otolaryngology, Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Qiang Du
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Jing Yu
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Xin-Wei Wang
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Xiao-Qing Qian
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Ya-Sheng Yuan
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Juan-Mei Yang
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Fang-Lu Chi
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China, .,Shanghai Auditory Medical Center, Shanghai, China, .,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China,
| | - Dong-Dong Ren
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.,Shanghai Auditory Medical Center, Shanghai, China.,Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
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Denoyelle F, Simon F, Chang KW, Chan KH, Cheng AG, Cheng AT, Choo DI, Daniel SJ, Farinetti A, Garabedian EN, Greinwald JH, Hoff SR, Hone S, Licameli GR, Papsin BC, Poe DS, Pransky S, Smith RJH, Triglia JM, Walton J, Zalzal G, Leboulanger N. International Pediatric Otolaryngology Group (IPOG) Consensus Recommendations: Congenital Cholesteatoma. Otol Neurotol 2020; 41:345-351. [DOI: 10.1097/mao.0000000000002521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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