Objective:This study aimed to report 9 venous thromboembolism(VTE)cases after extracranial otologic surgery and analyze the potential risk factors.Study design:Case series.Setting:Single tertiary-level academic center...Objective:This study aimed to report 9 venous thromboembolism(VTE)cases after extracranial otologic surgery and analyze the potential risk factors.Study design:Case series.Setting:Single tertiary-level academic center.Methods:Totally,9 cases of VTE were identified among adults who underwent extracranial otologic surgery at our hospital from January 2018 to December 2020.Caprini risk scores were calculated,and comprehensive preoperative,operative,and postoperative clinical data within 14 days were collected to assess the evidence of VTE.Results:The median age of 9 patients was 64 years old.Among them,7(77.8%)patients presented with intramuscular vein thrombosis,1(11.1%)patient had deep vein thrombosis,and 1(11.1%)patient experienced pulmonary embolism.Preoperatively,8(88.9%)patients had low or middle Caprini risk scores(≤4)with an average of 2.67±0.47 points.The average Caprini scores for all patients were 4.44±0.35 on postoperative day(POD)1 and 5.67±0.64 on POD14.D-dimer levels were collected,indicating an average of 0.55±0.17 mg/FEU preoperatively,8.53±3.94 mg/FEU at day 1,and 3.76±0.45 mg/FEU at POD14.In postoperative period,7(77.8%)patients experienced vertigo/dizziness and/or head immobility/bed rest.Conclusion:The present study highlighted that patients with low-and middle-risk of VTE undergoing otologic surgery should be also vigilant about postoperative VTE.Vertigo/dizziness and/or head immobility/bed rest in postoperative period should be considered as minor risk factors for developing VTE in patients undergoing extracranial otologic surgery.Conducting perioperative assessments,including Caprini risk score evaluation,Ddimer testing,and venous ultrasound of lower extremities,is recommended to ensure patients’safety.展开更多
Objective To test a modified otologic drill under different drilling conditions for its ability to identify drilling faults and stop drilling.Methods Based on force analysis and previous works,an otologic drill was mo...Objective To test a modified otologic drill under different drilling conditions for its ability to identify drilling faults and stop drilling.Methods Based on force analysis and previous works,an otologic drill was modified and equipped with three sensors.Under various conditions,the drill was used to simulate three drilling faults and normal drilling,and signals from the drill were analyzed to extract the characteristic signal.A multi-sensor information fusion system and a stop program were designed to recognize drilling faults and stop drilling.Results Signals from each sensor changed consistently in response to drilling condition changes,with high repeatability and regularity.The average identification rate was 72.625%,68.575%,70.5% and 81.3% respectively for the three simulated drilling faults and normal drilling.The stop program stopped drilling in 0.2～ 0.3 seconds when a drilling faults was detected.Conclusions This study shows that the forces acting on the drill bit change predictably in the three simulated drilling conditions;that using suitable BP neural networks,the drilling faults can be reliably identified,and that a stop program based upon characteristic signal recognition can stop drilling quickly upon detecting drilling faults.This lays a foundation for development of a system capable of predicting drilling faults and automatic drill control.Further studies are being undertaken for practical application of such a system.展开更多
<strong>Introduction:</strong> Military musicians are subjected to a double risk of noise related to the use of combat weapons and then to the use of musical instruments. The objective of this study was to...<strong>Introduction:</strong> Military musicians are subjected to a double risk of noise related to the use of combat weapons and then to the use of musical instruments. The objective of this study was to assess the otological damage of military music professionals in Cotonou. <strong>Methods:</strong> This was an analytical cross-sectional study carried out from July 15 to November 15, 2019. It focused on soldiers from the Music Squadron and the first Motorized Intervention Battalion of Camp Guézo in Cotonou. <strong>Results:</strong> 110 soldiers were included. The mean age was 34.3 ± 6.2 years. The sex ratio was 17.3. The instruments used were wind (74.5%), percussion (23.6%) and string (1.8%). The average length of service in the Music Squadron was 11.5 ± 6.7 years with extremes of 1 year and 25 years. They practiced military music for an average of 4.58 hours per day for 4 days per week. The mean sonometric measurement during training ranged from 89.1 dB (A) to 116.4 dB (A). Hearing loss was predominant in the military musicians group and was mild degree bilaterally (p = 0.002) and perceptual type (p = 0.007). <strong>Conclusion:</strong> Military musicians are exposed to high noise levels, putting them at risk of developing hearing problems that may limit their performance. The main otological morbidity found was hearing loss associated with a few cases of tinnitus and headache.展开更多
Otological injuries are common during cervicofacial trauma. The aim of this study is to describe the epidemiological characteristics and to map otological injuries during head and neck trauma. This was an observationa...Otological injuries are common during cervicofacial trauma. The aim of this study is to describe the epidemiological characteristics and to map otological injuries during head and neck trauma. This was an observational, descriptive, prospective study conducted at the ENT unit of the Referral Health Center Hospital in Mali from January 2017 to September 2018. Patients with middle and/or inner ear injuries due to trauma were included. The prevalence of otologic injuries was 34.54% of cases. The mean age was 25 years and the sex ratio was 1.11. Students accounted for 42.10%. The mechanism of occurrence was an intentional assault in 68.42% of the cases followed by road traffic accidents (15.79%). The most common functional signs were hearing loss (68.42%), tinnitus (57.89%), and facial paralysis in 5.26%. Otoscopy showed tympanic perforation (47.83%), otorrhagia (21.05%) and otoliquorrhea (5.26%). Rock fractures with osteodural breach (10.53%) and pneumencephaly were found on a CT scan of the rock. The evolution was marked by the regression of the facial paralysis and the healing of the tympanum in 45.45% of the cases. Sequelae persisted in the form of sensorineural deafness (17%). The otological lesions observed during cervicofacial trauma are varied. The challenges in our context are felt at three levels: the improvement of the technical platform, the long-term follow-up of patients, and the cost of care in terms of equipment. These lesions are responsible for disabling deafness, a source of difficulty in social and school integration.展开更多
Aim: To profile the diagnostic and the care provided for otological conditions in children. Method: This was a prospective cross-sectional study carried out from March 1, 2022 to May 30, 2022 at the ENT Unit of the Re...Aim: To profile the diagnostic and the care provided for otological conditions in children. Method: This was a prospective cross-sectional study carried out from March 1, 2022 to May 30, 2022 at the ENT Unit of the Reference Health Center of Commune V (Bamako). This study concerned the records of children with an otological condition. They were at their first consultation within the unit. The month of March was devoted to recruitment. The follow-up was done until the end of May. The parameters studied included epidemiological, clinical and therapeutic aspects. Results: We identified 184 children suffering from otological conditions out of a total of 559 patients that consulted during March 2022, i.e. an hospital prevalence of 32.9%. This study found ear infections in 60.3%. Earwax and epidermal plugs accounted for 32.60%. Traumatic injuries were 4.3%. Pre-lingual deafness was found in 1.1% of cases. Antibiotics were used for treatment in 66.3% of children without any complications detected. Conclusion: The otological affections of the child were frequent with a predominance of otitis.展开更多
Objective:There are few studies evaluating the impact of Aspirin-exacerbated respiratory disease(AERD)treatment on otologic symptoms.The aim of this study is to evaluate the effects of endoscopic sinus surgery(ESS)and...Objective:There are few studies evaluating the impact of Aspirin-exacerbated respiratory disease(AERD)treatment on otologic symptoms.The aim of this study is to evaluate the effects of endoscopic sinus surgery(ESS)and aspirin desensitization(AD)on otologic symptoms in subjects with AERD.Methods:Retrospective chart review of adult patients diagnosed with AERD at our tertiary Care Academic Medical Center-Otorhinolaryngology Department.Charts of adult patients diagnosed with AERD who underwent ESS and ASA desensitization at our institution’s AERD Center from 2016 to 2019 were reviewed.Sino-Nasal Outcomes Test 22-item survey(SNOT-22)scores were evaluated for patients at various time points including:pre-surgery,post-surgery/pre-aspirin desensitization,and various times post-desensitization up to>12 months.Within the SNOT-22,otologic-specific subdomain scores were evaluated at similar time points.Patients on immunomodulatory medications other than corticosteroids were excluded from analysis.Results:SNOT-22 scores were analyzed for 121 patients.There was a significant improvement in overall SNOT scores from pre-surgery(44.62)to post surgery/pre-desensitization(23.34)(P<0.0005).Similarly,SNOT-22 otologic-specific scores also improved after surgery prior to desensitization(3.19-2.04)(P=0.005).Following AD,the improvement in the overall SNOT-22 continued to improve for up to 12 months(P<0.005).While the otologic-specific SNOT-22 scores remained stable after surgery and ASA desensitization.Conclusion:ESS and AD reduce otologic-specific SNOT-22 scores and parallel trends in overall SNOT-22 scores.The effect of treatment is durable over the course of 12 months.Future work should aim to correlate otologic SNOT-22 scores with objective otologic data.展开更多
目的探讨先天性听骨链畸形的手术治疗效果。方法回顾性分析11例听骨链畸形患者术前行颞骨CT、声导抗及纯音测听检查,对不同畸形部位或类型者行不同术式人工听骨听骨链重建术,术后随访2个月～1年,评估患者术后听力情况。结果术前气导平...目的探讨先天性听骨链畸形的手术治疗效果。方法回顾性分析11例听骨链畸形患者术前行颞骨CT、声导抗及纯音测听检查,对不同畸形部位或类型者行不同术式人工听骨听骨链重建术,术后随访2个月～1年,评估患者术后听力情况。结果术前气导平均听阈(0.5、1、2和4 kHz)为(59.6±10.0)dB HL,骨气导差(38.9±8.0)dB HL。术后2个月～1年复查气导平均听阈(45.3±16.0)dB HL,骨气导差为(22.5±10.0)dB HL。术后气导增益(14.3±9.0)dB HL,骨气导差增益(16.4±8.0)dB HL。11例中7例(64%)术后气导增益≥15 dB HL,4例(36%)术后气导增益<15 dB HL;8例(73%)术后骨气导差增益≥15 dB HL,3例(27%)术后骨气导差增益<15 dB HL。结论人工听骨听骨链重建术是治疗听骨链畸形的方法之一。展开更多
BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an id...BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.展开更多
Cholesteatoma is a fairly otologic common problem. However, cholesteatoma invading the internal auditory canal (IAC) is rare and typically results in profound hearing loss and facial paralysis. This is a case of a 46-...Cholesteatoma is a fairly otologic common problem. However, cholesteatoma invading the internal auditory canal (IAC) is rare and typically results in profound hearing loss and facial paralysis. This is a case of a 46-year-old female with a history of prior right complex cholesteatoma that had undergone multiple procedures. She had multiple complications including right cerebral spinal fluid (CSF) leak, meningitis, recurrent mastoid bowl infections and right facial paralysis which resulted in multiple facial plastics procedures and overclosure of the right ear. Over the last three years, she has noticed an increase in right sided otalgia, facial pressure, facial numbness and headaches. An MRI temporal bone with diffusion weighted imaging (DWI) showed a DW positive soft tissue mass filling the mastoid bowl as well as extending into the IAC and cerebellar pontine angle (CPA) cistern with contact of the middle cerebellar peduncle and trigeminal nerve. A translabyrinthine approach to the IAC found the mastoid bowl to be filled with cholesteatoma and an osseous defect from the mastoid bowl along the labyrinthine facial nerve tracking cholesteatoma into the IAC/CPA. This case highlights the complex and aggressive nature a cholesteatoma can take and the need for diligent surveillance in any ear that had prior cholesteatoma. The utilizations of MRI temporal bone with diffusion weighted imaging allow for surveillance in an over closed ear canal that is vital to the care of cholesteatoma patients who have a similar history.展开更多
This is a case of a 60-year-old male with a history of prior left middle fossa meningioma that was partially resected with an operative report noting diffuse attachment to the middle fossa floor. Gamma knife was recom...This is a case of a 60-year-old male with a history of prior left middle fossa meningioma that was partially resected with an operative report noting diffuse attachment to the middle fossa floor. Gamma knife was recommended but he never completed this management. He then presented about eight years later with a mass from his left external auditory canal. It was reported that two years prior another surgeon operated on the left ear for a cholesteatoma. CT temporal bone showed complete opacification of left EAC, mastoid bowl, and remaining mastoid air cells. In addition, there were irregular bony/hyperostotic changes seen within the left sphenoid and temporal bone. There was dural thickening within the middle fossa adjacent to the previously described hyperostotic bony changes. A mastoidectomy and excision of mass revealed extensive adhesive tissue throughout the middle ear, and mastoid up to the tegmen. Pathology of the portions that were resected confirmed Grade 1 meningioma. Stereotactic gamma knife radiation was completed to the area to prevent further growth. This case highlights extracranial meningioma that did not have definitive management for prior middle fossa floor meningioma. It also highlights the need to think of less common pathology in the middle ear and external auditory canal.展开更多
文摘Objective:This study aimed to report 9 venous thromboembolism(VTE)cases after extracranial otologic surgery and analyze the potential risk factors.Study design:Case series.Setting:Single tertiary-level academic center.Methods:Totally,9 cases of VTE were identified among adults who underwent extracranial otologic surgery at our hospital from January 2018 to December 2020.Caprini risk scores were calculated,and comprehensive preoperative,operative,and postoperative clinical data within 14 days were collected to assess the evidence of VTE.Results:The median age of 9 patients was 64 years old.Among them,7(77.8%)patients presented with intramuscular vein thrombosis,1(11.1%)patient had deep vein thrombosis,and 1(11.1%)patient experienced pulmonary embolism.Preoperatively,8(88.9%)patients had low or middle Caprini risk scores(≤4)with an average of 2.67±0.47 points.The average Caprini scores for all patients were 4.44±0.35 on postoperative day(POD)1 and 5.67±0.64 on POD14.D-dimer levels were collected,indicating an average of 0.55±0.17 mg/FEU preoperatively,8.53±3.94 mg/FEU at day 1,and 3.76±0.45 mg/FEU at POD14.In postoperative period,7(77.8%)patients experienced vertigo/dizziness and/or head immobility/bed rest.Conclusion:The present study highlighted that patients with low-and middle-risk of VTE undergoing otologic surgery should be also vigilant about postoperative VTE.Vertigo/dizziness and/or head immobility/bed rest in postoperative period should be considered as minor risk factors for developing VTE in patients undergoing extracranial otologic surgery.Conducting perioperative assessments,including Caprini risk score evaluation,Ddimer testing,and venous ultrasound of lower extremities,is recommended to ensure patients’safety.
基金supported by Beijing Municipal Natural Science Foundation(4092027)
文摘Objective To test a modified otologic drill under different drilling conditions for its ability to identify drilling faults and stop drilling.Methods Based on force analysis and previous works,an otologic drill was modified and equipped with three sensors.Under various conditions,the drill was used to simulate three drilling faults and normal drilling,and signals from the drill were analyzed to extract the characteristic signal.A multi-sensor information fusion system and a stop program were designed to recognize drilling faults and stop drilling.Results Signals from each sensor changed consistently in response to drilling condition changes,with high repeatability and regularity.The average identification rate was 72.625%,68.575%,70.5% and 81.3% respectively for the three simulated drilling faults and normal drilling.The stop program stopped drilling in 0.2～ 0.3 seconds when a drilling faults was detected.Conclusions This study shows that the forces acting on the drill bit change predictably in the three simulated drilling conditions;that using suitable BP neural networks,the drilling faults can be reliably identified,and that a stop program based upon characteristic signal recognition can stop drilling quickly upon detecting drilling faults.This lays a foundation for development of a system capable of predicting drilling faults and automatic drill control.Further studies are being undertaken for practical application of such a system.
文摘<strong>Introduction:</strong> Military musicians are subjected to a double risk of noise related to the use of combat weapons and then to the use of musical instruments. The objective of this study was to assess the otological damage of military music professionals in Cotonou. <strong>Methods:</strong> This was an analytical cross-sectional study carried out from July 15 to November 15, 2019. It focused on soldiers from the Music Squadron and the first Motorized Intervention Battalion of Camp Guézo in Cotonou. <strong>Results:</strong> 110 soldiers were included. The mean age was 34.3 ± 6.2 years. The sex ratio was 17.3. The instruments used were wind (74.5%), percussion (23.6%) and string (1.8%). The average length of service in the Music Squadron was 11.5 ± 6.7 years with extremes of 1 year and 25 years. They practiced military music for an average of 4.58 hours per day for 4 days per week. The mean sonometric measurement during training ranged from 89.1 dB (A) to 116.4 dB (A). Hearing loss was predominant in the military musicians group and was mild degree bilaterally (p = 0.002) and perceptual type (p = 0.007). <strong>Conclusion:</strong> Military musicians are exposed to high noise levels, putting them at risk of developing hearing problems that may limit their performance. The main otological morbidity found was hearing loss associated with a few cases of tinnitus and headache.
文摘Otological injuries are common during cervicofacial trauma. The aim of this study is to describe the epidemiological characteristics and to map otological injuries during head and neck trauma. This was an observational, descriptive, prospective study conducted at the ENT unit of the Referral Health Center Hospital in Mali from January 2017 to September 2018. Patients with middle and/or inner ear injuries due to trauma were included. The prevalence of otologic injuries was 34.54% of cases. The mean age was 25 years and the sex ratio was 1.11. Students accounted for 42.10%. The mechanism of occurrence was an intentional assault in 68.42% of the cases followed by road traffic accidents (15.79%). The most common functional signs were hearing loss (68.42%), tinnitus (57.89%), and facial paralysis in 5.26%. Otoscopy showed tympanic perforation (47.83%), otorrhagia (21.05%) and otoliquorrhea (5.26%). Rock fractures with osteodural breach (10.53%) and pneumencephaly were found on a CT scan of the rock. The evolution was marked by the regression of the facial paralysis and the healing of the tympanum in 45.45% of the cases. Sequelae persisted in the form of sensorineural deafness (17%). The otological lesions observed during cervicofacial trauma are varied. The challenges in our context are felt at three levels: the improvement of the technical platform, the long-term follow-up of patients, and the cost of care in terms of equipment. These lesions are responsible for disabling deafness, a source of difficulty in social and school integration.
文摘Aim: To profile the diagnostic and the care provided for otological conditions in children. Method: This was a prospective cross-sectional study carried out from March 1, 2022 to May 30, 2022 at the ENT Unit of the Reference Health Center of Commune V (Bamako). This study concerned the records of children with an otological condition. They were at their first consultation within the unit. The month of March was devoted to recruitment. The follow-up was done until the end of May. The parameters studied included epidemiological, clinical and therapeutic aspects. Results: We identified 184 children suffering from otological conditions out of a total of 559 patients that consulted during March 2022, i.e. an hospital prevalence of 32.9%. This study found ear infections in 60.3%. Earwax and epidermal plugs accounted for 32.60%. Traumatic injuries were 4.3%. Pre-lingual deafness was found in 1.1% of cases. Antibiotics were used for treatment in 66.3% of children without any complications detected. Conclusion: The otological affections of the child were frequent with a predominance of otitis.
文摘Objective:There are few studies evaluating the impact of Aspirin-exacerbated respiratory disease(AERD)treatment on otologic symptoms.The aim of this study is to evaluate the effects of endoscopic sinus surgery(ESS)and aspirin desensitization(AD)on otologic symptoms in subjects with AERD.Methods:Retrospective chart review of adult patients diagnosed with AERD at our tertiary Care Academic Medical Center-Otorhinolaryngology Department.Charts of adult patients diagnosed with AERD who underwent ESS and ASA desensitization at our institution’s AERD Center from 2016 to 2019 were reviewed.Sino-Nasal Outcomes Test 22-item survey(SNOT-22)scores were evaluated for patients at various time points including:pre-surgery,post-surgery/pre-aspirin desensitization,and various times post-desensitization up to>12 months.Within the SNOT-22,otologic-specific subdomain scores were evaluated at similar time points.Patients on immunomodulatory medications other than corticosteroids were excluded from analysis.Results:SNOT-22 scores were analyzed for 121 patients.There was a significant improvement in overall SNOT scores from pre-surgery(44.62)to post surgery/pre-desensitization(23.34)(P<0.0005).Similarly,SNOT-22 otologic-specific scores also improved after surgery prior to desensitization(3.19-2.04)(P=0.005).Following AD,the improvement in the overall SNOT-22 continued to improve for up to 12 months(P<0.005).While the otologic-specific SNOT-22 scores remained stable after surgery and ASA desensitization.Conclusion:ESS and AD reduce otologic-specific SNOT-22 scores and parallel trends in overall SNOT-22 scores.The effect of treatment is durable over the course of 12 months.Future work should aim to correlate otologic SNOT-22 scores with objective otologic data.
文摘目的探讨先天性听骨链畸形的手术治疗效果。方法回顾性分析11例听骨链畸形患者术前行颞骨CT、声导抗及纯音测听检查,对不同畸形部位或类型者行不同术式人工听骨听骨链重建术,术后随访2个月～1年,评估患者术后听力情况。结果术前气导平均听阈(0.5、1、2和4 kHz)为(59.6±10.0)dB HL,骨气导差(38.9±8.0)dB HL。术后2个月～1年复查气导平均听阈(45.3±16.0)dB HL,骨气导差为(22.5±10.0)dB HL。术后气导增益(14.3±9.0)dB HL,骨气导差增益(16.4±8.0)dB HL。11例中7例(64%)术后气导增益≥15 dB HL,4例(36%)术后气导增益<15 dB HL;8例(73%)术后骨气导差增益≥15 dB HL,3例(27%)术后骨气导差增益<15 dB HL。结论人工听骨听骨链重建术是治疗听骨链畸形的方法之一。
文摘BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.
文摘Cholesteatoma is a fairly otologic common problem. However, cholesteatoma invading the internal auditory canal (IAC) is rare and typically results in profound hearing loss and facial paralysis. This is a case of a 46-year-old female with a history of prior right complex cholesteatoma that had undergone multiple procedures. She had multiple complications including right cerebral spinal fluid (CSF) leak, meningitis, recurrent mastoid bowl infections and right facial paralysis which resulted in multiple facial plastics procedures and overclosure of the right ear. Over the last three years, she has noticed an increase in right sided otalgia, facial pressure, facial numbness and headaches. An MRI temporal bone with diffusion weighted imaging (DWI) showed a DW positive soft tissue mass filling the mastoid bowl as well as extending into the IAC and cerebellar pontine angle (CPA) cistern with contact of the middle cerebellar peduncle and trigeminal nerve. A translabyrinthine approach to the IAC found the mastoid bowl to be filled with cholesteatoma and an osseous defect from the mastoid bowl along the labyrinthine facial nerve tracking cholesteatoma into the IAC/CPA. This case highlights the complex and aggressive nature a cholesteatoma can take and the need for diligent surveillance in any ear that had prior cholesteatoma. The utilizations of MRI temporal bone with diffusion weighted imaging allow for surveillance in an over closed ear canal that is vital to the care of cholesteatoma patients who have a similar history.
文摘This is a case of a 60-year-old male with a history of prior left middle fossa meningioma that was partially resected with an operative report noting diffuse attachment to the middle fossa floor. Gamma knife was recommended but he never completed this management. He then presented about eight years later with a mass from his left external auditory canal. It was reported that two years prior another surgeon operated on the left ear for a cholesteatoma. CT temporal bone showed complete opacification of left EAC, mastoid bowl, and remaining mastoid air cells. In addition, there were irregular bony/hyperostotic changes seen within the left sphenoid and temporal bone. There was dural thickening within the middle fossa adjacent to the previously described hyperostotic bony changes. A mastoidectomy and excision of mass revealed extensive adhesive tissue throughout the middle ear, and mastoid up to the tegmen. Pathology of the portions that were resected confirmed Grade 1 meningioma. Stereotactic gamma knife radiation was completed to the area to prevent further growth. This case highlights extracranial meningioma that did not have definitive management for prior middle fossa floor meningioma. It also highlights the need to think of less common pathology in the middle ear and external auditory canal.
