Сlinical observations of patients with petrous pyramid cholesteatoma

Anikin, I. A.; Khamgushkeeva, N. N.; Bokuchava, T. A.

doi:10.18692/1810-4800-2016-3-16-23

2016

DOI: 10.18692/1810-4800-2016-3-16-23

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Сlinical observations of patients with petrous pyramid cholesteatoma

I. A. Anikin¹,

N. N. Khamgushkeeva²,

T. A. Bokuchava³

Abstract: The article presents the clinical observation of 12 patients with chronic suppurative otitis media complicated with petrous pyramid cholesteatoma. According to the MoffatSmith 2008 classification, the following types of petrous pyramid cholesteatoma propagation have been revealed: supralabyrinthine (n = 1), supralabyrinthine – apical (n = 2), infralabyrinthine (n = 4), infralabyrinthine – apical (n = 3), massive (n = 1) and massiveapical (n = 1). We analyzed the clinical aspects of each post-surgery patie… Show more

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Sanation of petrous bone cholesteatoma in the otosurgical practice

Anikin

Khamgushkeeva

et al. 2017

Vestn. otorinolaringol.

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The present article reports the clinical cases of the surgical intervention on 20 patients presenting with petrous bone cholesteatoma. We have identified several clinical variants of petrous bone cholesteatoma based on the results of multispiral computed tomography (MSCT) of the temporal bones and categorized them into the following types in accordance with the classification proposed by Moffat-Smith an M. Sanna for this pathological condition: supralabyrinthine (n=8), supralabyrinthine-apical (n=2), infralabyrinthine (n=3), infralabyrinthine-apical (n=5), massive (n=1), and massive - apical (n=1). The surgical sanation of petrous bone cholesteatoma was performed in all the 20 patients in the absence of the pronounced bone destruction in the walls of the temporal bone pyramid and of the subdural expansion of cholesteatoma. In all the cases, the trepanation cavity remained open till its complete epidermization. The follow up period was around 3 years in duration on the average. The post-surgical analysis of the clinical conditions of each of the 20 patients was performed with special reference to the surgical technique applied for the removal of petrous bone cholesteatoma and the final outcome of the radical treatment.

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Sanation of petrous bone cholesteatoma in the otosurgical practice

Anikin

Khamgushkeeva

et al. 2017

Vestn. otorinolaringol.

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Classification of pathological epidermization (cholesteatoma) of the middle ear NMAO

2023

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The periodicals published over the past 5 years showed that interest in the issue of surgical treatment of chronic otitis media, including one complicated by cholesteatoma, did not wane despite the large accumulated experience of schools in otosurgery around the globe. In our opinion, there are currently some significant problems of terminology in the clinical anatomy of the ear, in particular, the nomenclature of the upper floor of tympanic cavity, which negatively affects the comparison and reproducibility of the results of surgical treatment of chronic otitis media. The critical analysis of the current classification of middle ear cholesteatoma proposed in 2017 and validated in Russia in 2021 demonstrates certain difficulties in using the pathohistological term “cholesteatoma”, as well as the basic inaccuracy in defining the concept and structure of the anterior parts of the epitympanum. The work aims to develop and present a new classification of pathological middle ear epidermization (cholesteatoma), which is based on the pathophysiology of middle ear ventilation. The modern concepts on the mechanisms of middle ear ventilation reveal its important role in developing the pathological epidermization and secondary cholesteatoma. The use of three-dimensional modelling of airway ventilation makes it substantially easier to follow the pathophysiological mechanisms of development of tympanic membrane retraction. The tympanic diaphragm consists of more than 10 composite elements. Understanding the pathophysiological principles underlies the proposed classification of pathological middle ear epidermization (cholesteatoma), which is based on the prevalence of middle ear and surrounding anatomical formation injuries. The pathological process area is coded using the abbreviation of the National Medical Association of Otorhinolaryngologists. In this abbreviation, each letter corresponds to a specific anatomical region. The tympanic diaphragm represents the boundary between the regions. Each letter is assigned an index corresponding to the degree of pathological epidermization invasion into the structures of the middle ear, temporal bone and cranial cavity. The authors provide a table, which serves as a visual aid for ease of coding the diagnosis. Examples of how to formulate a diagnosis in accordance with otoscopic illustrations are given.

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Сlinical observations of patients with petrous pyramid cholesteatoma

Cited by 2 publications

References 0 publications

Sanation of petrous bone cholesteatoma in the otosurgical practice

Sanation of petrous bone cholesteatoma in the otosurgical practice

Classification of pathological epidermization (cholesteatoma) of the middle ear NMAO

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