• Clinical and Experimental Otorhinolaryngology
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• 제11권4호
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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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• 제35권2호
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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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• 제61권12호
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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.

• 대한두경부종양학회지
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• 제31권1호
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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.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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• pp.40.1-40
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• 1981

만성중이염은 이과영역에 있어서 가장 빈도가 늪은 질병 중 하나이다. 그중 진주종성 중이염은 이경화증과 골파괴가 심하며, 골파괴의 방향이 안면신경관, 내이 또는 두개내로 진행되면 두개내 합병증이 일어날 수 있으며, 청력장애가 심한 것으로 근년에 이르리 항생물질 및 화학요법등의 치료법이 많은 발달을 가졌어도 최종적인 치료법은 수술요법 밖에 없다. 최근 저자들은 현훈을 주소로 한 22세 남자 환자에서 내이루공을 동반한 진주종성 중이염을 중이 및 유양돌기 근치수술을 시행함으로써 좋은 결과를 얻었기에 이를 문헌적 고찰과 함께 보고하는 바이다.

• Journal of Audiology & Otology
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• 제24권4호
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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.

• 대한청각학회지
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• 제24권4호
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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.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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• pp.39.3-40
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• 1981

후천적진주종의 형성에 있어서 고막의 Shrapnell부분과 외이도후상부 상피의 상고 실내 침입 및 고막 중심성천공의 margin으로부터 상피가 침입하는 이른바 immigration설과 이밖에 metaplasia설이 있다. 임상적으로 진주종이 상고실에 형성된다는 사실은 알려져 왔으나 그 발생기전에 대한 해명은 충분하지 않는 실정이다. 연자 등은 최근에 중이수술을 시행한 진주종 170례에 대하여 검토를 가하였다. 수술소견에 있어서 진주종의 primary focus가 상고실에 있을 때 Shrapnell부위의 marginal 및 central perforation 2가지 형의 천공이 관찰되었으며 Prussak's space안으로 retraction 및 Rivinus notch의 골벽결손 등을 볼 수 있었고 진주종이 있었던 36례중 Shrapnell부위의 중심성천공을 동반한 경우 5례, Rivinus notch의 골벽이 결손된 경우와 Shrapnell부위의 후상부 marginal perforation이 있고 진주종을 형성한 경우 21례, 그중 Shrapnell부위의 중심성천공을 동반한 경우 3례였다. 결론적으로 상고실 진주종이 잘 생기는 이유는 1) 상고실은 염증성분필물을 배설하는 구씨관입구와의 거리가 있고 2) 고막 Shrapnell부위의 고유층은 collagen fiber가 긴장부에 비해서 엷고 탄력성섬유가 많기 때문에 표피층의 각화증식을 일으킬 경우 Prussak's space내로 retraction을 일으키기 쉽다. 3) Shrapnell부위의 상부에 위치한 Rivinus notch에 부착한 epidermis는 각화증식에 의하여 Rivinus notch margin과 여기에 부착하고 있는 고막연의 margin사이를 파괴하여 상고실로 상피가 침입하게 된다.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2018년도 춘계 종합학술대회 논문집
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• pp.431-432
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• 2018

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1987년도 제21차 학술대회 연제순서 및 초록
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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.