Academic literature on the topic 'Cholestatome'

BACKGROUND Chronic otitis media (COM) of squamosal type is associated with cholestatoma with potential complications. Clinical examination and high resolution computed tomography (HRCT) scans are necessary to assess the disease site and extension. The purpose of the study was to compare the preoperative HRCT findings with the intraoperative surgical findings in squamosal type of chronic otitis media as well as various parameters in HRCT temporal bone and intraoperative findings. METHODS A prospective study was conducted on 30 patients aged between 18 and 60 years of both the genders who presented with chronic otitis media squamosal type, for a period of 22 months who attended the outpatient department of ENT. RESULTS HRCT findings and intraoperative findings were compared and results were analysed. Facial canal erosion (P - 0.0031), tegmen plate erosion (P - 0.0001), sigmoid sinus plate erosion (P - 0.002) were found to be statistically significant. Lateral semicircular canal fistula (P - 0.36) and ossicular status malleus (P - 1.000), incus (P - 0.949), stapes suprastructure (P - 0.984), and stapes footplate erosion (P - 0.977) were found to be statistically insignificant. CONCLUSIONS In our study, HRCT imaging for COM squamosal type, accurately depicted the soft tissue mass, erosion of tegmen plate, sigmoid sinus plate, scutum, lateral semicircular canal fistula, incus and suprastructure of stapes erosion and the same were found intraoperatively as well. Our study showed good comparison between the preoperative HRCT scans and the surgical findings in cholesteatoma cases. HRCT is confirmed to be valuable in the diagnosis and in guiding the surgical management of cholesteatoma. KEY WORDS Chronic Otitis Media, Cholesteatoma, HRCT Temporal Bone, Modified Radical Mastoidectomy

Objective: To compare the size of Ostmann’s fat pad (OFP) between healthy ears and ears with chronic otitis media with cholestatoma (COMwC) using magnetic resonance imaging (MRI). Methods: Twenty-six patients with unilateral COMwC underwent mastoidectomy. Pre-operative MRI records were reviewed retrospectively. The healthy ears served as the control group. OFP is represented by the maximum diameter of the high intensity area medial to the tensor veli palatini muscle (TVP); M1. A reference diameter was defined from the medial border of OFP reaching the medial border of the medial pterygoid muscle; M2. Values of M1, M2 and the ratio of M1:M2 was compared between the healthy and pathological ear in each patient. Results: All 26 patients (16 females,10 males) had unilateral cholestatoma. Mean age was 37.6 years (range 19-83). In the healthy (H) ears group, mean M1H was 2.04 ± 0.53 mm, mean M2H was 9.57 ± 2.57 mm. In the pathological (P) ears group; mean M1P was 2.03 ± 0.55 mm, mean M2P was 9.86 ± 2.37 mm. A comparison of M1 and M2 values between the healthy and pathological ear groups was not statistically significant ( P = .853 and P = .509, respectively). Mean M1H:M2H ratio in the healthy ears group was 0.22 ± 0.05, mean M1P:M2P ratio in the pathological ear group was 0.21 ± 0.06. A comparison between these ratios found no significant statistical correlation ( P = .607). Conclusion: The size of Ostmann’s fat pad does not affect the development of chronic otitis media with cholestatoma in adults.

Abstract Background Cholesteatoma and otitis media are common middle ear pathologies. They may cause serious complication such as hearing loss, facial nerve paralysis or intra-cranial complications in advanced cases. They are mainly diagnosed by otoscope yet CT examination is essential to confirm the diagnosis in some cases as well as assess its extensions for proper surgical excision. However, CT is poor in differentiation of cholesteatoma from other middle ear pathologies. Between the two diseases, there are a grey zone. Depending on CT images in differentiation between cholestatoma and otitis media, radiologist will be susptable for misdiagnosis. Objective To determine the diagnostic accuracy of DWI and the difference between the ADCs of middle ear cleft cholestatoma and those of non-cholesteatomatous tissue especially recurrent otitis media on single-shot echo planar DW images. In a case of cholestatoma, the results will be confirmed by intra-operative findings and histopathological data. In a case of otitis media, we will follow up the patients clinically if signs and symptoms resolve or not; or follow up by CT examination. Methods This study was conducted on patient with suspected cholesteatoma suspected clinically or by CT examination or known patients and patient also with suspected otitis media recurrence who underwent already surgery or preparing to that; at Ain Shams university hospitals. The patients referred from the otolaryngology department at Ain Shams university hospitals and from other private clinics. The patients was investigated using magnetic resonance imaging (MRI). Results MRI examination was advocated to differentiate between cholesteatoma from other middle ear pathologies. Delayed post contrast T1 images were used but showed low sensitivity for smaller lesions as well as patient inconvenience due to delayed imaging after 30-45 minutes. In recent years, diffusion weighted sequences have been used in diagnosis of cholesteatoma due to its bright signal on DWIs. In our study we used thin cut multi-shot EPI diffusion weighted images in the assessment of cholesteatoma and otitis media suspected clinically or by CT examination or known patients. It showed very good sensitivity and excellent specificity in detection of diffusion restriction of cholestatoma compared to chronic otits media which appear as a facilitated diffusion. The use of multi-shot techniques improved its sensitivity compared to single shot images yet it is still relatively less than non-EPI techniques. Conclusion DWI is a beneficial tool in the evaluation of cholesteatoma and differentiate between it and otitis media with excellent specificity that reduces the need of second look surgeries in multiple cases. The use of multi-shot diffusion weighted techniques improved its sensitivity significantly compared to single shot techniques. It still could not detect lesions smaller than 4 mm.