Archives of otolaryngology--head & neck surgery · 1995
Congenital cholesteatoma.
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Zappia J J, Wiet R J
Аннотация
OBJECTIVE: To review the characteristics of congenital cholesteatomata.
DESIGN: Case series.
SETTING: Tertiary care (referral-based) private practice.
PATIENTS AND OTHER PARTICIPANTS: Fourteen patients were included in the study. The diagnosis of congenital cholesteatoma was based on an intact tympanic membrane on physical examination; a history that excluded tympanic membrane perforation, otorrhea, or previous otologic procedure; and a documented cholesteatoma at the time of surgical removal.
INTERVENTION: Surgical procedures including tympanotomy, atticotomy, and tympanotomy with mastoidectomy were performed on all patients.
MAIN OUTCOME MEASURES: Removal of cholesteatoma.
RESULTS: Four of the 14 patients had lesions isolated to the anterosuperior quadrant of the tympanum; the remainder had more extensive disease with notable posterior tympanic involvement. Three of the patients underwent surgery for recidivism; none were from isolated anterior lesions. One of these patients was referred at the time of recurrence, one had known residual cholesteatoma, and one had recurrence.
CONCLUSIONS: Clinical presentation and surgical findings enable the differentiation of two separate sites of congenital cholesteatoma formation: the anterosuperior and posterior-superior regions of the tympanic cavity. Recidivism of the lesion appears more commonly with posterior-superior congenital cholesteatomas.
DESIGN: Case series.
SETTING: Tertiary care (referral-based) private practice.
PATIENTS AND OTHER PARTICIPANTS: Fourteen patients were included in the study. The diagnosis of congenital cholesteatoma was based on an intact tympanic membrane on physical examination; a history that excluded tympanic membrane perforation, otorrhea, or previous otologic procedure; and a documented cholesteatoma at the time of surgical removal.
INTERVENTION: Surgical procedures including tympanotomy, atticotomy, and tympanotomy with mastoidectomy were performed on all patients.
MAIN OUTCOME MEASURES: Removal of cholesteatoma.
RESULTS: Four of the 14 patients had lesions isolated to the anterosuperior quadrant of the tympanum; the remainder had more extensive disease with notable posterior tympanic involvement. Three of the patients underwent surgery for recidivism; none were from isolated anterior lesions. One of these patients was referred at the time of recurrence, one had known residual cholesteatoma, and one had recurrence.
CONCLUSIONS: Clinical presentation and surgical findings enable the differentiation of two separate sites of congenital cholesteatoma formation: the anterosuperior and posterior-superior regions of the tympanic cavity. Recidivism of the lesion appears more commonly with posterior-superior congenital cholesteatomas.