eMedicine Specialties > Radiology > Head/Neck

Temporal Bone, Acquired Cholesteatoma: Follow-up

Author: Salomon Waizel, MD, Associate Professor of Otolaryngology, Anahuac University; Consulting Surgeon, Department of Otolaryngology, Hospital De Especialidades, National Medical Center SXXI, IMSS
Coauthor(s): Jose German Grandvallet, MD, Consulting Surgeon, Department of Otolaryngology, Medica Sur Medical Center, Mexico; Anil Khosla, MBBS, Assistant Professor, Department of Radiology, Section of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Veterans Affairs Medical Center of St Louis
Contributor Information and Disclosures

Updated: May 1, 2007

Intervention

The treatment of temporal-bone acquired cholesteatomas is surgical. Two principal techniques are used, depending on the decision regarding how to manage the posterior external auditory canal wall. The canal-wall-up procedure involves preserving the posterior canal wall with or without a posterior tympanotomy. The posterior tympanotomy is performed through a triangle bounded by the fossa incudis, facial nerve, and chorda tympani nerve. The canal-wall-down procedure involves taking down the posterior canal wall to the vertical facial nerve and marsupializing the mastoid into the external ear canal. Canal-wall-down procedures can be divided into those in which the middle-ear space is preserved (modified radical mastoidectomy) and those in which the middle-ear space is eliminated and the eustachian tube plugged (radical mastoidectomy).

Medicolegal Pitfalls

  • Failure to diagnose a cholesteatoma is a pitfall. Patients often believe that the diagnosis should have been made earlier and specific treatment should have been initiated. Misdiagnosis or delay in diagnosis results in a higher morbidity rate.
  • Documenting cholesteatoma complications is important during the first patient visit because the complications of tympanomastoid surgery are similar to those produced by the cholesteatoma (eg, facial palsy, hearing loss) and may be result in legal issues.
 


More on Temporal Bone, Acquired Cholesteatoma

Overview: Temporal Bone, Acquired Cholesteatoma
Imaging: Temporal Bone, Acquired Cholesteatoma
Follow-up: Temporal Bone, Acquired Cholesteatoma
Multimedia: Temporal Bone, Acquired Cholesteatoma
References
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References

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Further Reading

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Keywords

keratoma, congenital cholesteatoma, primary acquired cholesteatoma

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Contributor Information and Disclosures

Author

Salomon Waizel, MD, Associate Professor of Otolaryngology, Anahuac University; Consulting Surgeon, Department of Otolaryngology, Hospital De Especialidades, National Medical Center SXXI, IMSS
Disclosure: Nothing to disclose.

Coauthor(s)

Jose German Grandvallet, MD, Consulting Surgeon, Department of Otolaryngology, Medica Sur Medical Center, Mexico
Disclosure: Nothing to disclose.

Anil Khosla, MBBS, Assistant Professor, Department of Radiology, Section of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Veterans Affairs Medical Center of St Louis
Anil Khosla, MBBS is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, American Society of Neuroradiology, North American Spine Society, and Radiological Society of North America
Disclosure: Nothing to disclose.

Medical Editor

David S Levey, MD, PhD, Orthopedic/Spine MRI TeleRadiologist, Radsource, LLC
David S Levey, MD, PhD is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America, and Texas Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

C Douglas Phillips, MD, Professor, Departments of Radiology, Neurosurgery, and Otolaryngology, University of Virginia Health Sciences Center
C Douglas Phillips, MD is a member of the following medical societies: American College of Radiology, American Medical Association, American Society of Head and Neck Radiology, American Society of Neuroradiology, Association of University Radiologists, and Radiological Society of North America
Disclosure: Amirsys Royalty Consulting

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Lawrence M Davis, MD, Assistant Professor of Diagnostic Imaging (Clinical), Department of Diagnostic Imaging, Warren Alpert Medical School at Brown University
Lawrence M Davis, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, American Society of Neuroradiology, Radiological Society of North America, and Rhode Island Medical Society
Disclosure: Nothing to disclose.

 
 
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