Surgical treatment of adult cholesteatoma: long-term follow-up using total reconstruction procedure without staging

Edfeldt, Lennart; Strömbäck, Karin; Kinnefors, Anders; Rask‐Andersen, Helge

doi:10.3109/00016489.2012.707333

Cited by 31 publications

(25 citation statements)

References 14 publications

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“…Notably, these figures are the same as reported earlier by our group at 6 year follow-up in 330 adult cholesteatoma patients [13].…”

Section: Discussionsupporting

confidence: 83%

“…Patients were operated for cholesteatoma by five otosurgeons using an identical technique, previously described as total reconstruction procedure (TRP). TRP was defined as a one-stage CWD procedure using a retro-auricular approach including wide meatoplasty, radical mastoidectomy, and total or partial removal of the bony canal wall followed by reconstruction and obliteration [13]. In cases with severe eustachian tube dysfunction a silastic sheet was inserted into the middle ear.…”

Section: Patientsmentioning

confidence: 99%

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Non-echo planar diffusion-weighted MRI increases follow-up accuracy after one-step step canal wall-down obliteration surgery for cholesteatoma

Edfeldt

Strömbäck

Danckwardt-Lillieström

et al. 2013

Acta Oto-Laryngologica

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Seven of 41 cases were evaluated as positive for cholesteatoma on non-EPI DW-MRI. Since one patient refused surgery six of these seven cases underwent surgical revision and all were verified. There was agreement between clinical and non-EPI findings in five of eight cases. EPI findings correlated poorly with non-EPI and clinical findings. Inter-rater agreement (Cohen's kappa) was 0.91 for non-EPI DW-MRI (p < 0.001) and -0.062 for EPI DW-MRI (p = 0.43).

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“…Notably, these figures are the same as reported earlier by our group at 6 year follow-up in 330 adult cholesteatoma patients [13].…”

Section: Discussionsupporting

confidence: 83%

Section: Patientsmentioning

confidence: 99%

Non-echo planar diffusion-weighted MRI increases follow-up accuracy after one-step step canal wall-down obliteration surgery for cholesteatoma

Edfeldt

Strömbäck

Danckwardt-Lillieström

et al. 2013

Acta Oto-Laryngologica

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“…Mastoid cavity obliteration using soft tissue flaps is considered highly effective (78%–100%) in solving a cavity problem; however, it is very difficult to compare them due to the variety of obliteration techniques . Also, a few authors have considered the effects of various soft tissue flaps on duration of epithelialization in CWD mastoidectomy.…”

Section: Discussionmentioning

confidence: 99%

Application of amniotic membrane for covering mastoid cavity in canal wall down mastoidectomy

et al. 2019

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Objective Prevention of granulation tissue formation and acceleration of epithelialization of the mastoid cavity in canal wall down (CWD) mastoidectomy by use of amniotic membrane (AM) as a biologic dressing. Study Design Prospective and randomized study. Methods During CWD mastoidectomy, an inferiorly base musculoperiosteal flap was rotated into the cavity. In order to coverage of this flap, the AM (75 ears) or the temporalis fascia (control group, 73 ears) was used. The times for mastoid cavity epithelialization were compared in both groups. Results In the AM group, duration of complete epithelialization of the cavity was 41.4 ± 7.7 days, whereas in the control group it was 59.2 ± 9.1 days. Duration of time for complete epithelialization in the AM group was shorter than in the control group, which was significant (P < 0.0001). Conclusion The use of AM in CWD mastoidectomy is beneficial in minimizing postoperative epithelialization time. Level of Evidence 1b Laryngoscope, 129:1453–1457, 2019

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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). Preventing secondary infection by aspiration of debris makes cholesteatoma less aggressive and decreases complications; however, regular treatment is needed throughout life.…”

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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Surgical treatment of adult cholesteatoma: long-term follow-up using total reconstruction procedure without staging

Cited by 31 publications

References 14 publications

Non-echo planar diffusion-weighted MRI increases follow-up accuracy after one-step step canal wall-down obliteration surgery for cholesteatoma

Non-echo planar diffusion-weighted MRI increases follow-up accuracy after one-step step canal wall-down obliteration surgery for cholesteatoma

Application of amniotic membrane for covering mastoid cavity in canal wall down mastoidectomy

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

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