• Clinical and Experimental Otorhinolaryngology
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• v.11 no.4
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• pp.233-241
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• 2018

Objectives. As endoscopic instrumentation, techniques and knowledges have significantly improved recently, endoscopic ear surgery has become increasingly popular. Transcanal endoscopic ear surgery (TEES) can provide better visualization of hidden areas in the middle ear cavity during congenital cholesteatoma removal. We aimed to describe outcomes for TEES for congenital cholesteatoma in a pediatric population. Methods. Twenty-five children (age, 17 months to 9 years) with congenital cholesteatoma confined to the middle ear underwent TEES by an experienced surgeon; 13 children had been classified as Potsic stage I, seven as stage II, and five as stage III. The mean follow-up period was 24 months. Recurrence of congenital cholesteatoma and surgical complication was observed. Results. Congenital cholesteatoma can be removed successfully via transcanal endoscopic approach in all patients, and no surgical complications occurred; only one patient with a stage II cholesteatoma showed recurrence during the follow-up visit, and the patient underwent revision surgery. The other patients underwent one-stage operations and showed no cholesteatoma recurrence at their last visits. Two patients underwent second-stage ossicular reconstruction. Conclusion. Although the follow-up period and number of patients were limited, pediatric congenital cholesteatoma limited to the middle ear cavity could be safely and effectively removed using TEES.

• Journal of Yeungnam Medical Science
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• v.35 no.2
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• pp.244-247
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• 2018

Congenital intratympanic membrane cholesteatoma (ITMC) is a rare type of congenital cholesteatoma located within the tympanic membrane. This lesion tends to increase in size over time. The development of ITMC can cause several complications such as hearing impairment, dizziness, facial palsy, and intracranial complications, similar to any other cholesteatoma. The treatment of congenital cholesteatoma requires the removal of the lesion through surgery, because disease progression induces bony destruction of the nearby tissue. Most patients presenting with this cholesteatoma type are also treated with primary surgical removal. However, we recently experienced a case of an ITMC that showed a natural transition to an external auditory canal cholesteatoma.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.710-713
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• 2018

A congenital cholesteatoma is a benign mass formed from the keratinizing stratified squamous epithelium. It usually occurs in young children's anterosuperior part of the middle ear. A congenital cholesteatoma which originates from mastoid temporal bone or expands to posterior cranial fossa is rare. Standard treatment of an intracranial cholesteatoma is surgical removal with craniotomy. A 69-year-old woman was diagnosed with a congenital cholesteatoma of mastoid temporal bone that expanded to the posterior cranial fossa, which was successfully treated with transmastoid marsupialization without craniotomy. This is a first documented case of a congenital cholesteatoma of mastoid temporal bone that expanded to posterior cranial fossa, which was successfully treated with transmastoid marsupialization without craniotomy.

• Korean Journal of Head & Neck Oncology
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• v.31 no.1
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• pp.47-49
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• 2015

An osteoma of the external auditory canal(EAC) is an uncommon benign tumor. If a canal obstruction occurs, ear fullness or conductive hearing loss can arise. But, the association of an osteoma with a cholesteatoma is extremely rare. Therefore, we report a case of a 35-year-old female patient with osteoma of temporal bone that was complicated with EAC cholesteatoma.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.40.1-40
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• 1981

The cholesteatoma is usually associated with chronic purulent otitis media and destroys the surrounding structures and may cause dangerous complications. The cholesteatoma with a positive fistula sign may be observed occasionally, if a softened area is formed in the bony capsule over a semicircular canal which exposed the membranous structure of the canal. Recently, the authors have experienced a case of cholesteatoma combined with labyrin thine fistula in a 22-year old male patient. We present this case with a brief review of the literatures.

• Journal of Audiology & Otology
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• v.24 no.4
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• pp.191-197
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• 2020

Background and Objectives: Autophagy is known to be associated with pathogen infection. However, the expression of autophagy-related proteins has not been studied in chronic otitis media without cholesteatoma (COM) or with cholesteatoma (CholeOM). This study aimed to determine whether there is a difference between COM and CholeOM in autophagy-related gene mRNA expression. Subjects and Methods: For 47 patients with chronic otitis media, the inflammatory tissues were classified into granulation tissue (COM) or cholesteatoma (CholeOM) according to biopsy results. Results: PI3K mRNA expression (COM vs. CholeOM, mean±SD, 0.009±0.010 vs. 0.003±0.004; p=0.004) was lower, whereas Beclin-1 mRNA expression (0.089±0.107 vs. 0.176±0.163; p=0.034) was higher in the CholeOM group. Expression of PI3K mRNA in the CholeOM group was lower than that in the COM subgroups with presence of bacteria (0.022±0.019 vs. 0.001±0.001; p=0.001), otorrhea (0.049±0.068 vs. 0.003±0.004; p=0.004), and hearing loss over 40 dB (0.083±0.130 vs. 0.003±0.004; p=0.005). Conclusions: The data suggested that different autophagy proteins play important roles in chronic otitis media according to the presence or absence of cholesteatoma.

• Korean Journal of Audiology
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• v.24 no.4
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• pp.191-197
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• 2020

Background and Objectives: Autophagy is known to be associated with pathogen infection. However, the expression of autophagy-related proteins has not been studied in chronic otitis media without cholesteatoma (COM) or with cholesteatoma (CholeOM). This study aimed to determine whether there is a difference between COM and CholeOM in autophagy-related gene mRNA expression. Subjects and Methods: For 47 patients with chronic otitis media, the inflammatory tissues were classified into granulation tissue (COM) or cholesteatoma (CholeOM) according to biopsy results. Results: PI3K mRNA expression (COM vs. CholeOM, mean±SD, 0.009±0.010 vs. 0.003±0.004; p=0.004) was lower, whereas Beclin-1 mRNA expression (0.089±0.107 vs. 0.176±0.163; p=0.034) was higher in the CholeOM group. Expression of PI3K mRNA in the CholeOM group was lower than that in the COM subgroups with presence of bacteria (0.022±0.019 vs. 0.001±0.001; p=0.001), otorrhea (0.049±0.068 vs. 0.003±0.004; p=0.004), and hearing loss over 40 dB (0.083±0.130 vs. 0.003±0.004; p=0.005). Conclusions: The data suggested that different autophagy proteins play important roles in chronic otitis media according to the presence or absence of cholesteatoma.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.39.3-40
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• 1981

Concerning the pathogenesis of acquired cholesteatoma in attic, there has been postulated theories by immigration from the Shrapnell's portion of the tympanic membrane, posterosuperior quardrant of the deep meatal skin and invagination of the margin of the central perforation. Otherwise, squamous metaplasia of the epithelium lining the middle ear cleft has been supported as a possible cause of cholesteatoma. Clinically, there has been known of the facts that cholesteatoma is formed in the attic but the pathogenesis concerning the acquired cholesteatoma is not still exactly reported. Recently, authors analyzed 170 cases of cholesteatomatous middle ear performed the operation to the middle ear cleft. On the operation finding, when the primary focus of the cholesteatoma was in the attic, we observed two types of perforation, marginal and central perforation in the Shrapnell's portion, and retraction to the Prussak's space, bony defect on the Rivinus notch. Among 36 cases of the cholesteatoma, the perforation of the Shrapnell's portion are 5 cases. Bony defect on the Rivinus notch and marginal perforation on the posterosuperior quadrant of the Shrapnell's portion are 21 cases. Among these cases, 3 cases are combined with central perforation of the Shrapnell's portion. Conclusively, the reasons that cholesteatoma is favorable site in the attic: 1) Excretion of the inflammatory discharge in the attic is difficult because of the distance of the E-tube. 2) The Shrapnell's portion has less collagen fiber than the pars tensa and it is thin because the elastic fibers are rich in it. It is easy to retract within the Prussak's space to the cases of keratinizing hyperplasia. 3) The epidermis attached at the Rivinus notch of the superior portion on the Shrapnell's portion is invaginated through the destructed bony wall of the Rivinus notch and the margin of the tympanic membrane in the response to the keratinizing hyperplasia.

• Proceedings of the Korea Contents Association Conference
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• 2018.05a
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• pp.431-432
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• 2018

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.11.1-11
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• 1987

1984년 3월부터 1987년 2월까지 3년동안 canal wall dorm tympanoplasty를 시행한 환자 27 명을 관찰하여 다음 결과를 우선 얻을 수 있었다. 수술후 추적기간은 평균 4.6개월(1개월부터 1년 반까지)로 남자 18명, 여자 9명이었으며 평균 연령은 23.4세(7세부터 44세까지)이었다. 수술시 병명은 진주종성 중이염이 17례 (63%), intact canal tympanoplasty with recurrent or residual cholesteatoma가 4례(15%), 중이 근치 수술이 4례(15%)이었다. 수술 중 소견은 malleus (M), incus(I), stapes(S)의 전체 괴사가 11례 (41%), M·I 괴사와 수평반규관 노출이 각각 5례 (38%)씩 차지했다. 청력증진은 청력증진술을 1차에 시행한 18예 중, 추적 가능한 15례 중에서 5례 (30%)가 수술 후 8주이상의 청력검사결과 평균 31.4/10.4㏈를 나타냈다. 수술후 합병증으로 외이도 성형술을 동시에 시행한 20례중 경미한 육아조직 발생이 6예(30%) 외이도 성형술을 시행치 않은 7례 중 경미한 농성이루가 3례 (43%)로 나타났다.