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Xue P, Wang Z, Chai Y, Si M, Hu L. Treatment of congenital middle ear cholesteatoma in children using endoscopic and microscopic ear surgeries: a case series. Front Pediatr 2024; 12:1336183. [PMID: 38853779 PMCID: PMC11157046 DOI: 10.3389/fped.2024.1336183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/29/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Surgical removal is widely employed in children with congenital middle ear cholesteatoma (CMEC). Here, we report the surgical outcomes of CMEC removal via endoscopic ear surgery (EES) and microscopic ear surgery (MES) in children. Methods Children with CMEC who underwent preoperative medical history inquiry, hearing test, endoscopic evaluation, and radiology imaging before receiving EES or MES were included. Postoperative audiological outcomes and recurrence rates were collected. Results Seventeen children (20 ears) with stage II-IV CMEC were included. Of those, 11 ears (55.0%) underwent EES, and 9 ears (45.0%) underwent MES. The follow-up time was 35 ± 13.5 months. One child in the EES group with stage III CMEC had a recurrence during the follow-up period. In the EES group, the average minimum diameter of the external auditory canal on the affected side was 5.8 mm (4.3-8.0 mm). No linear association was found between age and the minimum diameter of the external auditory canal. Discussion EES is a promising treatment option for children with early-stage CMEC because of its low recurrence rate and minimally invasive nature. The minimum diameter of the external auditory canal on the affected side should be meticulously examined when performing EES in children.
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Affiliation(s)
- Po Xue
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Zhaoyan Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yongchuan Chai
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Mingjue Si
- Department of Radiology, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lingxiang Hu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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Kwok HM, Cheung CHL, Ng TF, Lam SY, Wong KHS, Wong HL, Pan NY, Cheng LF, Ma KFJ. Congenital cholesteatoma: what radiologists need to know. Pediatr Radiol 2024; 54:620-634. [PMID: 38393651 DOI: 10.1007/s00247-024-05877-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
Congenital cholesteatoma is a rare, non-neoplastic lesion that causes conductive hearing loss in children. It is underrecognized and often diagnosed only when there is an established hearing deficit. In the pediatric population, hearing deficiency is particularly detrimental because it can impede speech and language development and, in turn, the social and academic well-being of affected children. Delayed diagnosis leads to advanced disease that requires more extensive surgery and a greater chance of recurrence. A need to promote awareness and recognition of this condition has been advocated by clinicians and surgeons, but no comprehensive imaging review dedicated to this entity has been performed. This review aims to discuss the diagnostic utility of high-resolution computed tomography and magnetic resonance imaging in preoperative and postoperative settings in congenital cholesteatoma. Detailed emphasis is placed on the essential preoperative computed tomography findings that facilitate individualized surgical management and prognosis in the pediatric population.
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Affiliation(s)
- Hoi Ming Kwok
- Department of Diagnostic and Interventional Radiology, LG1, Main Block, Princess Margaret Hospital, Kowloon, Hong Kong.
| | - Chun Hei Lewey Cheung
- Department of Diagnostic and Interventional Radiology, LG1, Main Block, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Ting Fung Ng
- Department of Diagnostic and Interventional Radiology, LG1, Main Block, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Sun Yu Lam
- Department of Diagnostic and Interventional Radiology, LG1, Main Block, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Ka Hon Stephen Wong
- Department of Diagnostic and Interventional Radiology, LG1, Main Block, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Ho Lim Wong
- Department of Diagnostic and Interventional Radiology, LG1, Main Block, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Nin Yuan Pan
- Department of Diagnostic and Interventional Radiology, LG1, Main Block, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Lik Fai Cheng
- Department of Diagnostic and Interventional Radiology, LG1, Main Block, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Ka Fai Johnny Ma
- Department of Diagnostic and Interventional Radiology, LG1, Main Block, Princess Margaret Hospital, Kowloon, Hong Kong
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李 雅, 周 函, 陆 玲, 戴 艳, 张 小, 陈 杰, 俞 晨, 钱 晓. [Diagnosis and treatment of congenital temporal bone cholesteatoma]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2023; 37:186-189;196. [PMID: 36843516 PMCID: PMC10320675 DOI: 10.13201/j.issn.2096-7993.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Indexed: 02/28/2023]
Abstract
Congenital temporal bone cholesteatoma is a rare lesion in otolaryngology.The disease is locally invasive and may lead to significant complications,including hearing loss(conductive or sensorineural), temporal bone destruction and intracranial invasion. This article reviews the characteristic symptoms of congenital temporal bone cholesteatoma, testing and imaging of the disease, stage and the current treatment options in order to promote awareness to this rare disease entity and perform early surgical treatment, effectively avoid the destruction of the temporal bone and its surrounding structures, thereby reducing the occurrence of complications. By improving the understanding of the disease and performing early surgical treatment, the destruction of the temporal bone and its surrounding structures can be effectively avoided, thereby reducing the occurrence of complications.
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Affiliation(s)
- 雅兰 李
- 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科 江苏省医学重点学科 南京鼓楼医院耳鼻咽喉研究所(南京,210008)Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline, Research Institute of Otolaryngology, Nanjing, 210008, China
| | - 函 周
- 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科 江苏省医学重点学科 南京鼓楼医院耳鼻咽喉研究所(南京,210008)Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline, Research Institute of Otolaryngology, Nanjing, 210008, China
| | - 玲 陆
- 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科 江苏省医学重点学科 南京鼓楼医院耳鼻咽喉研究所(南京,210008)Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline, Research Institute of Otolaryngology, Nanjing, 210008, China
| | - 艳红 戴
- 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科 江苏省医学重点学科 南京鼓楼医院耳鼻咽喉研究所(南京,210008)Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline, Research Institute of Otolaryngology, Nanjing, 210008, China
| | - 小莉 张
- 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科 江苏省医学重点学科 南京鼓楼医院耳鼻咽喉研究所(南京,210008)Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline, Research Institute of Otolaryngology, Nanjing, 210008, China
| | - 杰 陈
- 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科 江苏省医学重点学科 南京鼓楼医院耳鼻咽喉研究所(南京,210008)Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline, Research Institute of Otolaryngology, Nanjing, 210008, China
| | - 晨杰 俞
- 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科 江苏省医学重点学科 南京鼓楼医院耳鼻咽喉研究所(南京,210008)Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline, Research Institute of Otolaryngology, Nanjing, 210008, China
| | - 晓云 钱
- 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科 江苏省医学重点学科 南京鼓楼医院耳鼻咽喉研究所(南京,210008)Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline, Research Institute of Otolaryngology, Nanjing, 210008, China
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Clinical Analysis of 85 Cases of External Auditory Canal Cholesteatoma Surgery under Specialized Endoscopy. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9190241. [PMID: 36246977 PMCID: PMC9556175 DOI: 10.1155/2022/9190241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022]
Abstract
Objective To investigate the clinical characteristics, surgical experience, and surgical outcomes of external auditory canal cholesteatoma (EACC) surgery under endoscopic otolaryngoscopy. Methods A retrospective analysis of 85 EACC cases admitted to the Department of Otolaryngology, Renji Hospital, Shanghai Jiaotong University School of Medicine, from January 2016 to February 2021 was performed, followed by retrospective analysis of clinical data to explore the feasibility and clinical characteristics of all-oral endoscopic EACC surgery. A total of 85 EACC patients (90 ears) with a mean age of 49.93 ± 14.87 years were included in the study. According to Udayabhanu staging, 43 ears (47.78%) were stage I, 40 ears (44.44%) were stage II, and 7 ears (7.78%) were stage III. All patients underwent transendoscopic surgery. Results 79 ears (87.78%) underwent endoscopic EACC resection alone (+external auditory canal tumor resection/tympanostomy tube insertion), 9 ears (10%) underwent endoscopic EACC resection+tympanostomy+tympanoplasty, 1 ear (1.11%) underwent endoscopic EACC resection+tympanoplasty, and 2 ears (2.22%) underwent EACC resection+otolaryngotomy+tympanoplasty+auditory chain reconstruction endoscopically. Of these, 7 ears (7.78%) underwent auricular cartilage-chondroplasty and 2 ears (2.22%) underwent auricular cartilage membrane repair. All patients were reviewed at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year postoperatively. One patient with stage II external auditory atresia had a recurrence after 6 months and underwent endoscopic ear surgery (ESS) again. One patient with stage 2 atresia recurred after 1 year and again underwent endoscopic ear surgery. The rest of the patients recovered well after the surgery, and the grafts healed well. Conclusion EACC surgery through the external ear canal under a dedicated endoscope is a safe, reliable, and effective method. Patients with stage I and II external auditory canal cholesteatoma surgery under endoscopy have a rapid postoperative recovery with significant hearing improvement, and stage IIIA patients can also achieve good results under strict evaluation of indications.
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