Cholesteatoma: Is a second stage necessary?

Keeler, Jarrod A.; Kaylie, David M.

doi:10.1002/lary.25385

Cited by 20 publications

(12 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In approximately one-third of planned second-look procedures, a residual cholesteatoma can be found. 10 In well-reconstructed middle ears with normal postoperative clinical findings and good postoperative auditory results, a second-look procedure could be avoided in two-thirds of cases.…”

mentioning

confidence: 99%

Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation

Fischer¹,

Schartinger²,

Dejaco³

et al. 2019

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE: MR imaging has become an important tool for the detection of cholesteatomas of the middle ear. Various diffusion-weighted imaging sequences are available and have shown promising results. This study aimed to evaluate readoutsegmented echo-planar DWI for the detection of cholesteatoma and compare the results with surgical validation. MATERIALS AND METHODS: Fifty patients with chronic otitis media (24 females and 26 males; range, 12-76 years of age; mean age, 41 years) who underwent MR imaging before an operation of the middle ear (1-169 days) were included. The MR imaging protocol consisted of axial and coronal readout-segmented echo-planar DWI with b-values of 0 and 1000 s/mm 2 and 3-mm slice thickness. The readoutsegmented echo-planar diffusion-weighted images were fused with standard T2-weighted sequences for better anatomic assignment. The results of the MR imaging evaluation were correlated with the results from the operation. RESULTS: Readout-segmented echo-planar DWI detected 22 of the 25 cases of surgically proved cholesteatoma. It has an accuracy of 92% (95% confidence interval, 80.8%-97.8%), a sensitivity of 88%, a specificity of 96%, a positive predictive value of 96%, and a negative predictive value of 89%. In 1 case, a positive finding for cholesteatoma with readout-segmented echo-planar DWI could not be proved by histology, and in 3 cases, histology yielded a cholesteatoma that was not detected with MR imaging. CONCLUSIONS: Readout-segmented echo-planar DWI is a promising and reliable MR imaging sequence for the detection and exclusion of cholesteatoma.

show abstract

mentioning

confidence: 99%

Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation

Fischer¹,

Schartinger²,

Dejaco³

et al. 2019

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…While disease recurrence is not absolute, recurrence rates of approximately 32% in planned second-look procedures, similar to our identified 29%, have been reported. 26 A staged second-look procedures can be beneficial in some patients, 27 however this option may not be available in those who have undergone subtotal petrousectomy or aggressive skull base resection. Using DWI MRI, a highly specific and sensitive way to identify cholesteatoma within the temporal bone, lesions as small as 2-3 millimeters can be identified.…”

Section: Discussionmentioning

confidence: 99%

The Medially-Invasive Cholesteatoma: An Aggressive Subtype of a Common Pathology

Casazza

Carlson

Shelton

et al. 2020

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

Objective: Describe the outcomes of treatment for patients with cholesteatomas that are medially invasive to the otic capsule, petrous apex, and/or skull base. Study Design: Retrospective case series Setting: Two tertiary care academic centers. Patients: Patients surgically managed for medially-invasive cholesteatoma at two tertiary care institutions from 2001 to 2017. Interventions: Surgical management of medially-invasive cholesteatomas. Main Outcome Measures: The presenting symptoms, imaging, pre- and post-operative clinical course, and complications were reviewed. Results: Seven patients were identified. All patients had pre-operative radiographic evidence of invasive cholesteatoma with erosion into the otic capsule beyond just a lateral semicircular canal fistula. Five patients had a complex otologic history with multiple surgeries for recurrent cholesteatoma including three with prior canal wall down mastoidectomy surgeries. Average age at the time of surgery was 41.3 years (range 20-83). Two patients underwent a hearing preservation approach to the skull base while all others underwent a surgical approach based on the extent of the lesion. Facial nerve function was maintained at the pre-operative level in all but one patient. No patient developed cholesteatoma recurrence. Conclusions: The medially-invasive cholesteatoma demonstrates an aggressive, endophytic growth pattern, invading into the otic capsule or through the perilabyrinthine air cells to the petrous apex. Surgical resection remains the best treatment option for medially-invasive cholesteatoma. When CSF leak is a concern, a subtotal petrosectomy with closure of the ear is often necessary.

show abstract

“…This can lead to recurrent disease. Surgical resection of cholesteatoma can also be quite challenging, and residual cholesteatoma is often present after surgery 4 . The pathogenesis of acquired cholesteatoma is not clear.…”

Section: Introductionmentioning

confidence: 99%

MiR-508-3p promotes proliferation and inhibits apoptosis of middle ear cholesteatoma cells by targeting PTEN/PI3K/AKT pathway

Li¹

2021

Int. J. Med. Sci.

View full text Add to dashboard Cite

Cholesteatoma of the middle ear is a common disease in otolaryngology, which can lead to serious intracranial and extracranial complications. Recent studies showed that the dysregulation of microRNA may be involved in the formation of middle ear cholesteatoma. This study aimed to explore the regulatory effect of micro ribonucleic acid 508-3p (miR-508-3p) on proliferation and apoptosis of middle ear cholesteatoma cells and excavate its underlying regulatory mechanism. We found miR-508-3p expression was upregulated in tissues and cells of cholesteatoma which was inversely related to the expression of hsa_circ_0000007. Overexpression of miR-508-3p could notably facilitate cholesteatoma cell proliferation. Luciferase reporter assay showed that miR-508-3p bound the 3'-untranslated region of its downstream mRNA PTEN. Gain and loss of functions of miR-508-3p were performed to identify their roles in the biological behaviors of cholesteatoma cells, including proliferation and apoptosis. Rescue assays confirmed that PTEN could reverse the effect of miR-508-3p overexpression on cell proliferation. In a word, this study validated that the development of cholesteatoma may regulated by hsa_circ_0000007/miR-508-3p/ PTEN/ PI3K/Akt axis.

show abstract

Cholesteatoma: Is a second stage necessary?

Cited by 20 publications

References 5 publications

Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation

Readout-Segmented Echo-Planar DWI for the Detection of Cholesteatomas: Correlation with Surgical Validation

The Medially-Invasive Cholesteatoma: An Aggressive Subtype of a Common Pathology

MiR-508-3p promotes proliferation and inhibits apoptosis of middle ear cholesteatoma cells by targeting PTEN/PI3K/AKT pathway

Contact Info

Product

Resources

About