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Bilateral congenital cholesteatoma: Surgical treatment and considerations.

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords

Bilateral congenital cholesteatoma

Chronic otits media

Endoscopic ear surgery

Middle ear

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 28688558
OWN - NLM
STAT- MEDLINE
DA  - 20170709
DCOM- 20170803
LR  - 20170803
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 99
DP  - 2017 Aug
TI  - Bilateral congenital cholesteatoma: Surgical treatment and considerations.
PG  - 146-151
LID - S0165-5876(17)30254-9 [pii]
LID - 10.1016/j.ijporl.2017.06.006 [doi]
AB  - 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.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Marchioni, Daniele
AU  - Marchioni D
AD  - Department of Otolaryngology - Head & Neck Surgery, University of Verona,
      Piazzale Aristide Stefani, 1 37126 Verona, Italy.
FAU - Rubini, Alessia
AU  - Rubini A
AD  - Department of Otolaryngology - Head & Neck Surgery, University of Verona,
      Piazzale Aristide Stefani, 1 37126 Verona, Italy. Electronic address:
      [email protected]
FAU - Gonzalez-Navarro, Mauricio
AU  - Gonzalez-Navarro M
AD  - Center for Research in Infectious Diseases, National Institute of Respiratory
      Diseases, Mexico City, Mexico.
FAU - Alicandri-Ciufelli, Matteo
AU  - Alicandri-Ciufelli M
AD  - Department of Otolaryngology - Head & Neck Surgery, University Hospital of
      Modena, Via del Pozzo 71, 41100 Modena, Italy.
FAU - James, Adrian
AU  - James A
AD  - Department of Otolaryngology - Head & Neck Surgery, University of Toronto,
      Hospital for Sick Children, 555 University Avenue, Toronto, Canada.
FAU - Presutti, Livio
AU  - Presutti L
AD  - Department of Otolaryngology - Head & Neck Surgery, University Hospital of
      Modena, Via del Pozzo 71, 41100 Modena, Italy.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20170615
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
RN  - Cholesteatoma, Congenital
SB  - IM
MH  - Canada
MH  - Child
MH  - Child, Preschool
MH  - Cholesteatoma/*congenital/surgery
MH  - Cholesteatoma, Middle Ear/*surgery
MH  - Ear, Middle/*pathology
MH  - Endoscopy/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Hearing Tests
MH  - Hospitals, University
MH  - Humans
MH  - Male
MH  - Mastoid/surgery
MH  - Postoperative Complications/surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Tympanoplasty/methods
OTO - NOTNLM
OT  - Bilateral congenital cholesteatoma
OT  - Chronic otits media
OT  - Endoscopic ear surgery
OT  - Middle ear
EDAT- 2017/07/10 06:00
MHDA- 2017/08/05 06:00
CRDT- 2017/07/10 06:00
PHST- 2017/01/21 [received]
PHST- 2017/06/03 [revised]
PHST- 2017/06/09 [accepted]
AID - S0165-5876(17)30254-9 [pii]
AID - 10.1016/j.ijporl.2017.06.006 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2017 Aug;99:146-151. doi:
      10.1016/j.ijporl.2017.06.006. Epub 2017 Jun 15.