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The Journal of International Advanced... Jul 2022Congenital cholesteatomas account for just up to 5% of all cholesteatomas and most commonly arise in the petrous apex and middle ear. Congenital cholesteatomas arising...
BACKGROUND
Congenital cholesteatomas account for just up to 5% of all cholesteatomas and most commonly arise in the petrous apex and middle ear. Congenital cholesteatomas arising in the mastoid are rare and typically present late.
METHODS
In this study, we report a case series of 3 cases managed in our department between 2006 and 2021 and present a summary of the current literature.
RESULTS
Congenital cholesteatomas arising in the mastoid is a rare finding and even among reported cases, not all are clearly mastoid in origin. Their location allows for considerable growth before symptoms develop. Pain and localized swelling in the temporal area are the most common presenting symptoms which can lead to diagnostic challenges. Our cases show that although surgery is often appropriate, conservative manage- ment may be suitable in certain situations.
CONCLUSION
Congenital cholesteatoma of mastoid origin is rare and can present a diagnostic challenge. Greater awareness is important to facilitate early detection. A high index of suspicion is needed in those presenting with retro-auricular pain and swelling in the context of a normal ontological examination.
Topics: Bone Diseases; Cholesteatoma; Cholesteatoma, Middle Ear; Ear, Middle; Earache; Humans; Mastoid
PubMed: 35072629
DOI: 10.5152/iao.2022.21450 -
The Journal of International Advanced... Dec 2020A case of mastoid dermoid cyst (DC) was presented, and differences with cases of other temporal bone DCs were analyzed. The mastoid DC was also compared with mastoid... (Review)
Review
A case of mastoid dermoid cyst (DC) was presented, and differences with cases of other temporal bone DCs were analyzed. The mastoid DC was also compared with mastoid congenital cholesteatoma. We reported a case of a patient with mastoid DC, evaluating her clinical, radiological, and surgical findings. A review of the literature was performed to compare our findings with those reported. The preoperative radiological evaluation prompted us to plan a surgical approach to the lesion, suspecting the presence of a mastoid congenital cholesteatoma. The surgical findings were in line with the presence of a mastoid DC. Only two cases reported in the literature presented features that fulfilled the criteria of a true mastoid DC. A DC confined to the mastoid region is an extremely rare clinical entity, with asymptomatic and slow growth. Preoperative radiological differentiation between congenital cholesteatoma and DCs with atypical features can be difficult. However, surgical excision is the treatment of choice in both cases. Diagnosis is confirmed by the histological evaluation.
Topics: Cholesteatoma, Middle Ear; Dermoid Cyst; Female; Humans; Magnetic Resonance Imaging; Mastoid; Middle Aged
PubMed: 33136032
DOI: 10.5152/iao.2020.7854 -
Ear, Nose, & Throat Journal May 2022We report a case of primary temporal bone diffuse B-cell non-Hodgkin lymphoma, which is a rare entity. A 71-year-old male with a history of dementia and hemicraniectomy...
We report a case of primary temporal bone diffuse B-cell non-Hodgkin lymphoma, which is a rare entity. A 71-year-old male with a history of dementia and hemicraniectomy presented due to 1 month of a pronounced left ulcerative mastoid lesion. Strikingly, there were no cranial nerve deficits which was unexpected due to the degree of the lesion. Initially, infectious mastoiditis was suspected based on physical examination alone. Due to the patient being a poor historian, it was difficult to determine whether this was an acute or chronic issue. Temporal bone squamous cell carcinoma, infectious mastoiditis, and actinomycosis were on the differential, but biopsies revealed non-Hodgkin lymphoma.
Topics: Actinomycosis; Aged; Diagnosis, Differential; Humans; Lymphoma, Non-Hodgkin; Male; Mastoid; Mastoiditis; Temporal Bone
PubMed: 32841094
DOI: 10.1177/0145561320950493 -
European Annals of Otorhinolaryngology,... May 2017The Eustachian (auditory) tube and tympanomastoid cavities form an anatomic and functional whole that cannot easily be divided, and is therefore known as the... (Review)
Review
The Eustachian (auditory) tube and tympanomastoid cavities form an anatomic and functional whole that cannot easily be divided, and is therefore known as the "tubotympanic system". The system has been the focus of several studies, with complex and sometimes contradictory results, making an overview of its functioning difficult to obtain. The objective of the present article is to review the current state of knowledge, as an indispensable preliminary to understanding tubotympanic system dysfunction, and notably the development of chronic otitis. The system as a whole is covered by mucosa, which provides continuity, although with certain particularities from one area to another, and plays a primordial role. Thus, under physiological conditions, gas diffusion across the tympanomastoid mucosa largely ensures the equilibrium of pressure between the middle ear and outside environment, the tube orifice being very little involved. Under large rapid change in atmospheric pressure, the aeration function of the Eustachian tube comes into play, governed by a reflex mechanism. The system also has other functions that are essential to good middle-ear functioning: protection against nasopharyngeal secretions and pathogens and against certain physiological noises; middle-ear cavity clearance by mucociliary transport of pathogens, partly related to submucosal gland secretion; and immune defense.
Topics: Chronic Disease; Ear, Middle; Eustachian Tube; Humans; Mastoid; Mucociliary Clearance; Otitis Media, Suppurative; Tympanic Membrane Perforation
PubMed: 28461039
DOI: 10.1016/j.anorl.2017.03.010 -
The Journal of International Advanced... Aug 2018The aim of this scoping review was to evaluate existing classifications of surgical procedures of the middle ear and mastoid and find a suitable classification that... (Review)
Review
OBJECTIVES
The aim of this scoping review was to evaluate existing classifications of surgical procedures of the middle ear and mastoid and find a suitable classification that could serve as an international standard.
MATERIALS AND METHODS
Scoping review with a systematic literature search using reference tracking and a syntax including all surgical procedures in mastoid and middle ear surgery and their synonyms. Studies were selected based on inclusion and exclusion criteria.
RESULTS
Eleven reported classifications were included; six of which focused on middle ear surgery, two on mastoid surgery, and three on both. However, none of the classifications included all current surgical procedures of mastoid and middle ear surgery.
CONCLUSION
Many classifications have been proposed for innumerable surgical techniques in middle ear and mastoid surgery. Some are outdated, some are incomplete, most are not widely accepted, and only few correspond with all current surgical techniques.
Topics: Ear, Middle; Humans; Mastoid; Mastoidectomy; Otologic Surgical Procedures; Registries; Tympanoplasty
PubMed: 30100541
DOI: 10.5152/iao.2018.5570 -
Indian Journal of Dental Research :... 2013Goldenhar syndrome is a syndrome of complex structures developing from first and second branchial arches during blastogenesis. The etiology of this rare disease is not...
Goldenhar syndrome is a syndrome of complex structures developing from first and second branchial arches during blastogenesis. The etiology of this rare disease is not fully understood, as it has shown itself variable genetically and of unclear causes. The disorder is characterized by a wide spectrum of symptoms and physical features that may vary greatly in range and severity from case to case. Here we present a unique case of Goldenhar syndrome with absence of left condyle, hypoplasia of the zygomatic bone, no pneumatization of the mastoid process, underdeveloped mandible, bifid tongue and the skin tags in the preauricular area.
Topics: Adolescent; Ear, External; Female; Goldenhar Syndrome; Humans; Mandible; Mandibular Condyle; Mastoid; Open Bite; Tongue; Zygoma
PubMed: 23852257
DOI: 10.4103/0970-9290.114952 -
Otology & Neurotology : Official... Jan 2011Using image-guided surgical techniques, we propose that an industrial robot can be programmed to safely, effectively, and efficiently perform a mastoidectomy.
HYPOTHESIS
Using image-guided surgical techniques, we propose that an industrial robot can be programmed to safely, effectively, and efficiently perform a mastoidectomy.
BACKGROUND
Whereas robotics is a mature field in many surgical applications, robots have yet to be clinically used in otologic surgery despite significant advantages including reliability and precision.
METHODS
We designed a robotic system that incorporates custom software with an industrial robot to manipulate a surgical drill through a complex milling profile. The software controls the movements of the robot based on real-time feedback from a commercially available optical tracking system. The desired path of the drill to remove the desired volume of mastoid bone was planned using computed tomographic scans of cadaveric specimens and then implemented using the robotic system. Bone-implanted fiducial markers were used to provide accurate registration between computed tomographic and physical space.
RESULTS
A mastoid cavity was milled on 3 cadaveric specimens with a 5-mm fluted ball bit. Postmilling computed tomographic scans showed that, for the 3 specimens, 97.70%, 99.99%, and 96.05% of the target region was ablated without violation of any critical feature.
CONCLUSION
To the best of our knowledge, this is the first time that a robot has been used to perform a mastoidectomy. Although significant hurdles remain to translate this technology to clinical use, we have shown that it is feasible. The prospect of reducing surgical time and enhancing patient safety by replacing human hand-eye coordination with machine precision motivates future work toward translating this technique to clinical use.
Topics: Fiducial Markers; Humans; Mastoid; Otologic Surgical Procedures; Robotics
PubMed: 21042227
DOI: 10.1097/MAO.0b013e3181fcee9e -
European Archives of... Aug 2023It is unusual to have communication from the external auditory canal (EAC) directly to the mastoid, totally sparing the tympanum. These patients need a different...
PURPOSE
It is unusual to have communication from the external auditory canal (EAC) directly to the mastoid, totally sparing the tympanum. These patients need a different surgical approach, a modified canal wall-down procedure, to completely clear the disease but fully preserve the tympanum. We present one such exceptional case.
CASE PRESENTATION
A 28-year-old lady presented with ear discharge for 1 year. Imaging confirmed the canal-mastoid fistula, but the entire tympanum was normal. We performed a modified-modified radical mastoidectomy.
CONCLUSIONS
Canal-mastoid fistula is an infrequent entity and may be idiopathic. Despite being evident on clinical examination, imaging aids in assessing size and location of the defect. Although EAC reconstruction may be attempted, the majority require a canal wall-down procedure.
Topics: Female; Humans; Adult; Mastoidectomy; Retrospective Studies; Mastoid; Ear, Middle; Ear Diseases; Ear Canal; Cholesteatoma, Middle Ear
PubMed: 37195344
DOI: 10.1007/s00405-023-08021-w -
Otolaryngology--head and Neck Surgery :... Jan 2017Objective The aim of this report is to provide a review of the current literature for assessment of performance for mastoidectomy, to identify the current assessment... (Review)
Review
Objective The aim of this report is to provide a review of the current literature for assessment of performance for mastoidectomy, to identify the current assessment tools available in the literature, and to summarize the evidence for their validity. Data Sources The MEDLINE database was accessed via PubMed. Review Methods Inclusion criteria consisted of English-language published articles that reported use of a mastoidectomy performance assessment tool. Studies ranged from 2007 to November 2015 and were divided into 2 groups: intraoperative assessments and those performed with simulation (cadaveric laboratory or virtual reality). Studies that contained specific reliability analyses were also highlighted. For each publication, validity evidence data were analyzed and interpreted according to conceptual definitions provided in a recent systematic review on the modern framework of validity evidence. Conclusions Twenty-three studies were identified that met our inclusion criteria for review, including 4 intraoperative objective assessment studies, 5 cadaveric studies, 10 virtual reality simulation studies, and 4 that used both cadaveric assessment and virtual reality. Implications for Practice A review of the literature revealed a wide variety of mastoidectomy assessment tools and varying levels of reliability and validity evidence. The assessment tool developed at Johns Hopkins possesses the most validity evidence of those reviewed. However, a number of agreed-on specific metrics could be integrated into a standardized assessment instrument to be used nationally. A universally agreed-on assessment tool will provide a means for developing standardized benchmarks for performing mastoid surgery.
Topics: Clinical Competence; Humans; Mastoid; Osteotomy; Quality Assurance, Health Care
PubMed: 27677598
DOI: 10.1177/0194599816670886 -
Acta Otorrinolaringologica Espanola 2015
Topics: Animals; Humans; Infant, Newborn; Mastoid; Petrous Bone; Semicircular Ducts; Tomography, X-Ray Computed
PubMed: 24342700
DOI: 10.1016/j.otorri.2013.07.008