Residual cholesteatoma: Prevalence and location. Follow-up strategy in adults - 02/06/12
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Summary |
Objectives |
To assess prevalence and location of residual cholesteatoma following closed “canal wall up” tympanoplasty (CWUT). The evolution of follow-up strategy is discussed.
Patients and methods |
A retrospective study was run in adults operated on by CWUT for middle-ear cholesteatoma and who had undergone second look surgery and/or postoperative radiology (CT-scan, diffusion-weighted MRI).
Results |
One hundred and nine patients (113 ears) underwent the procedure. Mean follow-up was 48months (range, 24–96months). Twenty-nine residual cholesteatomas were found (25%), including 11 located in the anterior attic (38%). Follow-up included 77 second look operations (70%), and 71 radiological examinations (62 CT-scans and nine diffusion-weighted MRIs). Second look surgery was without benefit for the patient (no residual, no ossiculoplasty) in one third of cases.
Conclusion |
Residual cholesteatoma in the anterior attic is a problem in CWUT. When postoperative auditory results are good, second look surgery should not be systematic but guided by high quality imaging.
Le texte complet de cet article est disponible en PDF.Keywords : Residual cholesteatoma, Middle ear, Second look surgery, CT, Diffusion-weighted MRI
Plan
Vol 129 - N° 3
P. 136-140 - juin 2012 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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