Surgical management of cholesteatoma: The two main options and the third way – atticotomy/limited mastoidectomy

Use of Non-Echo-Planar Diffusion-Weighted MR Imaging for the Detection of Cholesteatomas in High-Risk Tympanic Retraction Pockets

“…This makes postoperative care easier but impedes direct observation of the mastoidectomy during otomicroscopy, making it impossible to clinically detect residual and recurrent cholesteatomas. 33 Current indications for DWI in cholesteatomas have focused on congenital and residual/recurrent disease, 10 because they can be hidden or difficult to evaluate via otoscopy and postsurgical inflammation may lead to confusion on CT and standard MR imaging. DWI is also helpful in distinguishing differential diagnoses of middle ear masses, especially when combined with delayed postcontrast T1WI.…”

Can Long-Term Hearing Preservation be Expected in Children following Cholesteatoma Surgery? Results from a 14-Year-Long Study of Atticotomy-Limited Mastoidectomy with Cartilage Reconstruction

“…The two main approaches for cholesteatoma are canal wall up and canal wall down mastoidectomy [Nikolopoulos and Gerbesiotis, 2009]. However, a technically feasible and safe alternative to conventional canal wall up or down technique, atticotomy-limited mastoidectomy with cartilage reconstruction (inside-out ap- [Sadé and Halevy, 1976] and Tos [Tos and Poulsen, 1980] classifications.…”

“…However, a technically feasible and safe alternative to conventional canal wall up or down technique, atticotomy-limited mastoidectomy with cartilage reconstruction (inside-out ap- [Sadé and Halevy, 1976] and Tos [Tos and Poulsen, 1980] classifications. In cases of eardrum perforation, destruction of <50% of the middle ear mucosa is scored as 2 and >50% is scored as 3. proach), has been widely used by many surgeons in the treatment of cholesteatoma [Dornhoffer, 2000;Lan et al, 2003;DeRowe et al, 2005;Uyar et al, 2006;Nikolopoulos and Gerbesiotis, 2009;Roth and Haeusler, 2009;Hatano et al, 2010]. This method is a less invasive option that produces satisfactory long-term outcomes [Nikolopoulos and Gerbesiotis, 2009].…”

“…1 a, c, e, g), or atticoantro-mastoidectomy (red line on fig. 1 a, d, e, h) open cavity [Nikolopoulos and Gerbesiotis, 2009]. Cartilage was harvested from either the cavum or cymba conchae or both.…”

Sinus Tympani y recidiva en cirugía de colesteatoma

“…Mantener el CAE intacto presenta ventajas en relación a los cuidados posoperatorios, permitiendo que éste se pueda mojar y, de esta manera, no limitar las actividades futuras del paciente, hecho que resulta particularmente importante en pacientes jóvenes 5 . Sin embargo, esta alternativa quirúrgica se asocia a altas tasas de enfermedad residual y recidiva recomendándose una cirugía de revisión 6 .…”