Residual cholesteatoma: Prevalence and location. Follow-up strategy in adults

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• 作者：L. Gaillardin^a ; ^c ; ^{lgailorl@gmail.com} ; E. Lescanne^a ; ^c ; S. Moriniè ; re^a ; ^c ; J.-P. Cottier^b ; ^c ; A. Robier^a ; ^c
• 关键词：Residual cholesteatoma ; Middle ear ; Second look surgery ; CT ; Diffusion-weighted MRI
• 刊名：European Annals of Otorhinolaryngology ; Head and Neck Diseases
• 出版年：2012
• 期刊代码：pca156_18797296
• 类别：med
• 出版时间：June, 2012
• 卷：129
• 期：3
• 页码：136-140
• 文件大小：274 K

摘要

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Summary

Objectives

To assess prevalence and location of residual cholesteatoma following closed 鈥渃anal wall up鈥?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 48 months (range, 24-96 months). 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.