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2015, Number 2

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Rev Cubana Pediatr 2015; 87 (2)

Surgical behavior and preoperative complications of the giant cholesteatoma

Quintero NJL, Hernández CMC, Álvarez LI, Garmendía GFA, Carrillo VB, Báez AL

Language: Spanish
References: 31
Page: 192-204
PDF size: 176.11 Kb.


ABSTRACT

Introduction: although the incidence of complications in the chronic temporal bone infections has decreased, they remain a potential threat in terms of morbidity and mortality.
Objective: to characterize the pediatric patients who are operated on for complicated acquired giant cholesteotomas.
Methods: prospective and descriptive study of 11 pediatric patients with giant cholesteatomas and preoperative complications; they had been attended to and operated on at the otorrhinolaryngology service of "William Soler" pediatric hospital in the period of January 2011 through January 2013. The postoperative follow-up lasted 6 year. These patients were performed otoscopy, otomicroscopy, mastoid X rays, CT for hearing, as well as audiometric studies preoperatively and postoperatively. The surgical technique was the open one combined with timpanoplasty and ossiculoplasty in one-stage. Postsurgical functional hearing problems and relapses were all analyzed.
Results: the most frequent locations of marginal perforations were anteroposterior flaccid pars (n= 5; 45.46 %) followed by posterosuperior mesotympanic (n= 4; 36.46 %). Preoperative extracranial complications prevailed (81.82 %). There was preoperative anacusia (n= 2, laberintitis). There were no perioperative complications. The most relevant surgical finding was facial tympanic dehiscence (n= 7; 63.64 %) that matched the results of the preoperative tomography. Tympanoplasty and ossiculoplasty were performed in seven patients, type III (n= 7; 71.42 %), with average preoperative hearing loss of 53dB and postoperative one of 38 dB. Four patients were reoperated.
Conclusions: the used technique shows satisfactory surgical and postsurgical functional results.


REFERENCES

  1. Mustafa A, Kuçi S, Behramaj A. Management of cholesteatoma complications. Our experience in 145 cases. Indian J Otol. 2014;20:45-7.

  2. Wu JF, Jin Z, Yang JM, Liu YH, Duan ML. Extracranial and intracranial complications of otitis media: 22 year clinical experience and analysis. Acta Otolaryngol. 2012 Mar;132(3):261-5.

  3. El-Kashlan HK, Harker LA, Shelton C, Aygun N, Niparko JK. Otology, Neuro-otology, and Skull Base Surgery. Middle Ear, Mastoid, and Temporal Bone. Complications of Temporal Bone Infections. In: Flint PW, Haughey BH, Lund VJ, Niparko JK, Richardson MA, Robbins KT, et al. Cummings Otolaryngology-Head and Neck Surgery. 5th ed. Philadelphia: Mosby; 2010. p. 1979-98.

  4. Dubey SP, Larawin V. Complications of chronic suppurative otitis media and their management. Laryngoscope. 2007 Feb;117(2):264-7.

  5. Smith JA, Danner CJ. Complications of Chronic Otitis Media and Cholesteatoma. Otolaryngol Clin North Am. 2006 Dec;39(6):1237-55.

  6. Senn P, Haeusler R, Panosetti E, Caversaccio M. Petrous Bone Cholesteatoma Removal with Hearing Preservation. Otol Neurotol. 2011 Feb;32(2):236-41.

  7. Roth TN, Haeusler R. Inside-out technique cholesteatoma surgery: a retrospective long-term analysis of 604 operated ears between 1992 and 2006. Otol Neurotol. 2009 Jan;30(1):59-63.

  8. Hernández LE, Hernández G. Incidencia de infección y factores relacionados en pacientes tratados con mastoidectomía radical por otitis media crónica. An Orl Mex. 2008;53(3):124-8.

  9. De Foer B, Vercruysse JP, Pouillon M, Somers T, Casselman JW, Offeciers E. Value of high-resolution computed tomography and magnetic resonance imaging in the detection of residual cholesteatomas in primary bony obliterated mastoids. Am J Otolaryngol. 2007 Jul-Aug;28(4):230-4.

  10. Yu Z, Han D, Dai H, Zhao S, Zheng Y. Diagnosis of the pathological exposure of the mastoid portion of the facial nerve by CT scanning. Acta Otolaryngol. 2007 Mar;127(3):323-7.

  11. Nadol JB Jr. Revision mastoidectomy. Otolaryngol Clin North Am. 2006 Aug;39(4):723-40.

  12. Phelan E, Harney M, Burns H. Intraoperative findings in revision canal wall down mastoidectomy. Ir Med J. 2008 Jan;101(1):14.

  13. Yung M, Jacobsen NL, Vowler SL. A 5-years observational study of the outcome in pediatric cholesteatoma surgery. Otol Neurotol. 2007 Dec;28(8):1038-40.

  14. Campos-Navarro L, Barrón-Sotob M, Fajardo-Dolci G. Otitis media aguda y crónica, una enfermedad frecuente y evitable. Rev Fac Med UNAM. 2014 Enero- Febrero;57(1):5-14.

  15. Quintero JL. Otitis media crónica. En: De la Torre E, Pelayo EJ, editores. Pediatría. La Habana: Editorial Ciencias Médicas; 2011. p. 2644-54.

  16. Iñiguez-Cuadra R, Alobid I, Borés-Domenech A, Menendez-Colino LM, Caballero-Borrego M, Bernal Sprekelsen M. Type III tympanoplasty with titanium total ossicular replacement prosthesis: anatomic and functional results. Otol Neurotol. 2010 Apr;31(3):409-14.

  17. Liu W, Xie S, Chen X, Rao X, Ren H, Hu B, et al. Activation of the IL-6/JAK/STAT3 signaling pathway in human middle ear cholesteatoma epithelium. Int J Clin Exp Pathol. 2014 Jan 15;7(2):709-15.

  18. Maresh A, Martins OF, Victor JD, Selesnick SH. Using surgical observations of osicular erosion patterns to characterize cholesteatoma growth. Otol Neurotol. 2011 Oct;32(8):1239-42.

  19. Grewal DS, Hathiram BT, Saraiya SV. Canal wall-down tympanomastoidectomy: the “on-disease” approach for retraction pockets and cholesteatoma. J Laryngol Otol. 2007 Sep;121(9):832-9.

  20. Ceylan A, Bayazit Y, Yilmaz M, CelenK F, Bayramoglu I, Uygur K, et al. Extracranial complications of chronic otitis media. Int Adv Otol. 2009;5(1):51-5.

  21. Copeland BJ, Buchman CA. Management of labyrinthine fistulae in chronic ear surgery. Am J Otolaryngol. 2003 Jan-Feb;24(1):51-60.

  22. Szyfter W, Kruk-Zagajewska A, Borucki L. Results of treatment of 101 otogenic brain abscesses-56-years experience. Otolaryngol Pol. 2011 Mar-Apr;65(2):88-96.

  23. Wanna GB, Dharamsi LM, Moss JR, Bennett ML, Thompson RC, Haynes DS. Contemporary management of intracranial complications of otitis media. Otol Neurotol. 2010 Jan;31(1):111-7.

  24. Lin JW, Oghalai JS. Can Radiologic Imaging Replace Second-Look Procedures for Cholesteatoma? Laryngoscope. 2011 Jan;121(1):4-5.

  25. Quintero-Noa JL, Álvarez Lam I, Hernández Cordero MC, Meléndez Quintero LL. Complicaciones de las otitis medias agudas y crónicas en el niño. Rev Cubana Pediatr. 2013 Mar;85(1):89-105.

  26. Dornhoffer JL, Colvin GB, North P. Evidence of residual disease in ossicles of patients undergoing cholesteatoma removal. Acta Otolaryngol. 1999 Jan;119(1):89-92.

  27. Vaamonde-Lago P, Frade-González C, Castro-Vilas C, Lechuga-García R, Labella-Caballero T. Resultados de la timpanoplastia con antroexclusión en el tratamiento del colesteatoma de oído medio. Acta Otorrinolaringol Esp. 2001;52(1):9-13.

  28. Cabra J, Monux A. Efficacy of cartilage palisade tympanoplasty: randomized controlled trial. Otol Neurotol. 2010 Jun;31(4):589-95.

  29. Chiossone-Lares E, Chiossone-Kerdel JA. Bases Biofísicas para la reconstrucción de la cadena osicular. En: Rivas JA, Ariza HF, editores. Tratado de Otología y Audiología. Diagnóstico y Tratamiento Médico Quirúrgico. 2 ed. Bogotá: Amolca; 2007. p. 339-45.

  30. Quaranta N, Iannuzzi L, Petrone P, D'Elia A, Quaranta A. Quality of life after cholesteatoma surgery: Intact-canal wall tympanoplasty versus canal-down tympanoplasty with mastoid obliteration. Ann Otol Rhinol Laryngol. 2014 Feb;123(2):89-93.

  31. Ranciæ D. The use of total ossicular replacement prosthesis alter radical tympanomastoidectomy. Vojnosanit Pregl. 2013 May;70(5):463-8.




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