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Cholesteatoma

Cholesteatoma. Case History Ossicular Reconstruction Cholesteatoma Case 1. 12 yr old male Left Congenital Cholesteatoma Surgical Reconstruction of ossicular chain and tympanoplasty. SRT/WR. Audio. Cholesteatoma Case 2. 58 y/o female Hx of bilateral cholesteatoma

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Cholesteatoma

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  1. Cholesteatoma

  2. Case History Ossicular Reconstruction Cholesteatoma Case 1 • 12 yr old male • Left Congenital Cholesteatoma • Surgical Reconstruction of ossicular chain and tympanoplasty

  3. SRT/WR

  4. Audio

  5. Cholesteatoma Case 2 • 58 y/o female • Hx of bilateral cholesteatoma • Hx of multiple bilateral ossicular chain reconstructions, stapedectomy and tympanoplasty • Hx of mastoidectomy

  6. Cholesteatoma Case 3 • 57 y/o male • Hx of Left tympanoplasty, mastoidectomy, and ossicular chain reconstruction

  7. Cholesteatoma Case 4 History • 12 y/o Male • History of right cholesteotoma • Hx of Eustachian Tube dysfuction • Removed cholesteotoma and placed subannular tubes in May 04

  8. Otoscopy • Bilateral atelactasis • No tubes • Pin point perferation right?

  9. Case 5 History • 62 year old female • Recent right tympanoplasty and ossicular chain prosthesis placement 6 months prior

  10. Otoscopy • Right reveals a well healed tympanic graft • Left is within normal limits

  11. Cholesterol granuloma History • 41 year old male • Six to eight week history of low-grade left sided headaches – aggrivated by straining and valsalva. • Recent transient stabbing type pain in left temporal area • Sent to Shands after a CT scan showed a cholesterol granuloma – for biopsy/draining

  12. CT Scan (note our patient has it on the opposite side, it is in the middle ear space)

  13. Otoscopy • There are exostoses in both ear canals obscuring full view of TM

  14. Case 6 History • 79 year old male • Recent tympanoplasty and canaloplasty for a right cholesteatoma

  15. Otoscopy • Pnematic otoscopy reveals grade 4 atelactasis left posterosuperior tympanic membrane with no evidence of cholesteatoma • Right TM is intact

  16. Case 7 History • 13 year old female • History of left cholesteatoma • Underwent tympanoplasty, modified radical mastoidectomy and ossicular chain reconstruction 3 years prior

  17. Otoscopy • Granulation tissue found in left mastoid bulb – cauterized with silver nitrate • TM on left within normal limits • Right TM has developed a retraction of the pars flaccida onto the incus and pars tensa onto the promontory. • Weber lateralizes to the right

  18. Case 8 History • 65 year old female • History of right traumatic perforation with subsequent cholesteatoma • Right tympanoplasty, bony canaloplasty and ossicular chain reconstruction

  19. Otoscopy • Left is within normal limits • Right external auditory canal showed scant dry skin and residue from sterois drops – removed • Graft is healed and there is no evidence of cholesteatoma

  20. Case 9 History • Preoperative consultation for possible left cholesteatoma • History of chronic ear infections • Imaging done one month prior showed soft tissue density consistent with cholesteatoma

  21. Otoscopy • Right is within normal limits • Left TM is inflamed and opacified

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