Canal-Down Mastoidectomy: Experience in 81 Cases

Garap, Joseph P.; Dubey, Siba P.

doi:10.1097/00129492-200107000-00006

Cited by 39 publications

(29 citation statements)

References 16 publications

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“…The postmastoidectomy course can be complicated by wound problems (7.7–42.1%), deafness (1.7–9%), vertigo, tinnitus, facial nerve paralysis (1.7–4%), recurrent cholesteatoma (5–66%), lateralized or perforated tympanic membrane (1–5%), posterior canal wall atrophy (4.8%), retroauricular defect or fistula, stenosis or atresia of an external auditory canal (7–23%), taste disturbances, postoperative discharging ear (1.7–59%) and CSF leakage [1,2,3,4,5,6,7]. …”

Section: Discussionmentioning

confidence: 99%

Intracranial Complications following Mastoidectomy

Migirov¹,

Eyal

Kronenberg³

2004

Pediatr Neurosurg

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Mastoidectomy is a common surgical procedure in otology. However, postoperative complications of various degrees of severity may occur. We present4 children who underwent mastoidectomy for middle ear and mastoid disease and developed postoperative intracranial complications. One child was operated on for brain abscess 1 week after the initial mastoidectomy. Another child appeared with seizures 5 days after the initial mastoidectomy and a subdural empyema was drained during revision surgery. Large bone defects with exposed middle cranial fossa dura were found at revision surgery in both cases and Proteus vulgaris and methicillin-resistant Staphylococcus aureus were isolated from the mastoid and abscess cavities in these children. A small epidural collection was diagnosed in the third patient 2 days after initial mastoid surgery and was managed with intravenous antibiotics only. The other child was found to have sigmoid sinus thrombosis the day after mastoidectomy that was performed for nonresponsive acute mastoiditis. This child received both intravenous antibiotics and anticoagulants. Timely revision surgery, combinations of third- or fourth-generation cephalosporins with vancomycin or metronidazole and the addition of anticoagulants in cases of sinus thrombosis can lead to full recovery.

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Section: Discussionmentioning

confidence: 99%

Intracranial Complications following Mastoidectomy

Migirov¹,

Eyal

Kronenberg³

2004

Pediatr Neurosurg

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“…76 Although most posterior cranial base tumors such as E. C. Tsai, S. Santoreneos, and J. 39,97 chordoma, 13 and chondrosarcoma 38 are more common in adults, other rare tumors such as Ewing sarcoma are more common in children. 49 We will review the current management strategies associated with cholesteatomas, chordomas and chondrosarcomas, and Ewing sarcoma.…”

Section: Tumors Of the Posterior Cranial Base In Childrenmentioning

confidence: 99%

Tumors of the skull base in children: review of tumor types and management strategies

Tsai¹,

Santoreneos²,

Rutka³

2002

FOC

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Although many treatment strategies for skull base tumors in adults have been reported, relatively little has been reported regarding such therapies in the pediatric population. Skull base tumors in children present a therapeutic challenge because of their unique pathological composition, the constraints of the maturing skull and brain, and the small size of the patients. In this review, the authors examine the pediatric skull base lesions that occur in the anterior, middle, and posterior cranial base, focusing on unique pediatric tumors such as encepahalocele, fibrous dysplasia, esthesioneuroblastoma, craniopharyngioma, juvenile nasopharyngeal angiofibroma, cholesteatoma, chordoma, chondrosarcoma, and Ewing sarcoma. They review management strategies that include radio- and chemotherapy, as well as surgical approaches with emphasis on the modifications and complications associated with the procedures as they apply in children. Evidence for the advantages and limitations of radiotherapy, chemotherapy, and surgery as it pertains to the pediatric population will be examined. With a working knowledge of skull base anatomy and special considerations of the developing craniofacial skeleton, neurosurgeons can treat skull base lesions in children with acceptable morbidity and mortality rates. Outcomes in this population may be better than those in adults, in part because of the benign histopathology that frequently affects the pediatric skull base, as well as the plasticity of the maturing nervous system.

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“…Complications of surgery, such as deafness, dizziness, and facial nerve palsy, can sometimes occur (65)(66)(67). Furthermore, it sometimes makes it difficult to identify recurrent or residual cholesteatoma (68,69).…”

Section: Discussionmentioning

confidence: 99%

Intercellular Communication between Keratinocytes and Fibroblasts Induces Local Osteoclast Differentiation: a Mechanism Underlying Cholesteatoma-Induced Bone Destruction

Iwamoto

Nishikawa

Imai

et al. 2016

Molecular and Cellular Biology

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Bone homeostasis is maintained by a balance in activity between bone-resorbing osteoclasts and bone-forming osteoblasts. Shifting the balance toward bone resorption causes osteolytic bone diseases such as rheumatoid arthritis and periodontitis. Osteoclast differentiation is regulated by receptor activator of nuclear factor B ligand (RANKL), which, under some pathological conditions, is produced by T and B lymphocytes and synoviocytes. However, the mechanism underlying bone destruction in other diseases is little understood. Bone destruction caused by cholesteatoma, an epidermal cyst in the middle ear resulting from hyperproliferation of keratinizing squamous epithelium, can lead to lethal complications. In this study, we succeeded in generating a model for cholesteatoma, epidermal cyst-like tissue, which has the potential for inducing osteoclastogenesis in mice. Furthermore, an in vitro coculture system composed of keratinocytes, fibroblasts, and osteoclast precursors was used to demonstrate that keratinocytes stimulate osteoclast differentiation through the induction of RANKL in fibroblasts. Thus, this study demonstrates that intercellular communication between keratinocytes and fibroblasts is involved in the differentiation and function of osteoclasts, which may provide the molecular basis of a new therapeutic strategy for cholesteatoma-induced bone destruction. Bone is a highly dynamic organ in which homeostasis is maintained by a balance in activity between bone-resorbing osteoclasts and bone-forming osteoblasts. An imbalance between osteoclastic and osteoblastic activity causes various skeletal disorders. Osteoclasts are multinucleate cells that differentiate from mononuclear macrophage/monocyte-lineage hematopoietic precursor cells, which are attracted to the bloodstream by factors, including sphingsine-1 phosphate (1, 2). Osteoclast differentiation and function are regulated by macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor B ligand (RANKL) (3-5). Under physiological conditions, osteoblasts or osteocytes are the source of RANKL (6-8). RANKL-mediated osteoclastogenesis also plays an important role in bone destruction in inflammatory bone diseases such as rheumatoid arthritis (RA) or periodontal diseases. In such pathological states, synoviocytes or immune cells, such as B or T lymphocytes, infiltrating into the area are proposed to be the major sources of RANKL (9-11). In RA, infiltration of T helper 17 (Th17) cells is observed in the synovium. Th17 cells indirectly induce RANKL expression in synoviocytes by producing interleukin-17 (IL-17) (12), and Th17 cells themselves express RANKL on their plasma membrane (13). Thus, in many bone destructive diseases, the mechanisms of bone destruction are becoming clarified in detail. However, there are still certain bone destructive diseases whose underlying mechanisms remain to be elucidated. Cholesteatoma, a benign entity arising in temporal bone, is one such disease where our understanding is limited.Cholesteatoma is an epid...

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Canal-Down Mastoidectomy: Experience in 81 Cases

Cited by 39 publications

References 16 publications

Intracranial Complications following Mastoidectomy

Intracranial Complications following Mastoidectomy

Tumors of the skull base in children: review of tumor types and management strategies

Intercellular Communication between Keratinocytes and Fibroblasts Induces Local Osteoclast Differentiation: a Mechanism Underlying Cholesteatoma-Induced Bone Destruction

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