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Fulltext Congenital cholesteatoma: delayed diagnosis and its consequences

Goh BS, Faizah AR, Salina H, Asma A, Saim L

Med J Malaysia, 2010 Sep;65(3):196-8.
PMID: 21939167

This is a retrospective review of congenital cholesteatoma cases that were managed surgically. There were 5 cases. The age of presentation ranged from 5 to 18 year old. Three patients presented with complication of the disease. Three patients had intact tympanic membrane, two had perforation at the anterior superior quadrant. All patients had cholesteatoma medial to tympanic membrane. Four cases had extensive ossicular erosion with preoperative hearing worse than 40 dB. Four cases underwent canal wall down mastoid surgery and one underwent canal wall up surgery. One patient had recurrence which required revision surgery. In conclusion, congenital cholesteatoma presented late due to the silent nature of disease in its early stage. Extensive disease, ossicular destruction with risk of complication at presentation were marked in our study. Hence, more aggressive surgical intervention is recommended in the management of congenital cholesteatoma.

Matched MeSH terms: Cholesteatoma, Middle Ear/surgery
Long-term status of middle-ear aeration post canal wall down mastoidectomy

Ezulia T, Goh BS, Saim L

J Laryngol Otol, 2019 Aug;133(8):662-667.
PMID: 31267884 DOI: 10.1017/S0022215119001385

BACKGROUND: Retraction pocket theory is the most acceptable theory for cholesteatoma formation. Canal wall down mastoidectomy is widely performed for cholesteatoma removal. Post-operatively, each patient with canal wall down mastoidectomy has an exteriorised mastoid cavity, exteriorised attic, neo-tympanic membrane and shallow neo-middle ear.
OBJECTIVE: This study aimed to clinically assess the status of the neo-tympanic membrane and the exteriorised attic following canal wall down mastoidectomy.
METHODS: All post canal wall down mastoidectomy patients were recruited and otoendoscopy was performed to assess the neo-tympanic membrane. A clinical classification of the overall status of middle-ear aeration following canal wall down mastoidectomy was formulated.
RESULTS: Twenty-five ears were included in the study. Ninety-two per cent of cases showed some degree of neo-tympanic membrane retraction, ranging from mild to very severe.
CONCLUSION: After more than six months following canal wall down mastoidectomy, the degree of retracted neo-tympanic membranes and exteriorised attics was significant. Eustachian tube dysfunction leading to negative middle-ear aeration was present even after the canal wall down procedure. However, there was no development of cholesteatoma, despite persistent retraction.

Matched MeSH terms: Cholesteatoma, Middle Ear/surgery*
The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

Murray AR, Atkinson L, Mahadi MK, Deuchars SA, Deuchars J

Auton Neurosci, 2016 08;199:48-53.
PMID: 27388046 DOI: 10.1016/j.autneu.2016.06.004

The human ear seems an unlikely candidate for therapies aimed at improving cardiac function, but the ear and the heart share a common connection: the vagus nerve. In recent years there has been increasing interest in the auricular branch of the vagus nerve (ABVN), a unique cutaneous subdivision of the vagus distributed to the external ear. Non-invasive electrical stimulation of this nerve through the skin may offer a simple, cost-effective alternative to the established method of vagus nerve stimulation (VNS), which requires a surgical procedure and has generated mixed results in a number of clinical trials for heart failure. This review discusses the available evidence in support of modulating cardiac activity using this strange auricular nerve.

Matched MeSH terms: Ear/surgery
A giant mastoid cholesteatoma with posterior cranial extension causing mass effect and obstructive hydrocephalus

Sabir BI, Rahmat K, Bux SI, Rajagopal NS, Looi LM, Sia SF

Clin Neurol Neurosurg, 2013 Oct;115(10):2192-6.
PMID: 23791432 DOI: 10.1016/j.clineuro.2013.05.023
Matched MeSH terms: Cholesteatoma, Middle Ear/surgery*