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 Hx of multiple bilateral ossicular chain

reconstructions, stapedectomy and tympanoplasty

Hx of mastoidectomy

Cholesteatoma Case 3

57 y/o male Hx of Left tympanoplasty,

mastoidectomy, and ossicular chain reconstruction

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

Otoscopy

Bilateral atelactasis No tubes Pin point perferation right?

Case 5 History

62 year old female Recent right tympanoplasty and

ossicular chain prosthesis placement 6 months prior

Otoscopy

Right reveals a well healed tympanic graft

Left is within normal limits

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

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

Otoscopy

There are exostoses in both ear canals obscuring full view of TM

Case 6 History

79 year old male Recent tympanoplasty and canaloplasty

for a right cholesteatoma

Otoscopy

Pnematic otoscopy reveals grade 4 atelactasis left posterosuperior tympanic membrane with no evidence of cholesteatoma

Right TM is intact

Case 7 History

13 year old female History of left cholesteatoma Underwent tympanoplasty, modified

radical mastoidectomy and ossicular chain reconstruction 3 years prior

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

Case 8 History

65 year old female History of right traumatic perforation

with subsequent cholesteatoma Right tympanoplasty, bony canaloplasty

and ossicular chain reconstruction

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

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

Otoscopy

Right is within normal limits Left TM is inflamed and opacified

Case 10 History

69 yr old male current Right TM perf Hx of left TM perf with

canaloplasty/tympanoplasty performed on the left ear

Synthetic ossicular chain reconstruction with stapedectomy in Aug 2005

Case 11 History

65 y/o male Motor Vehicle Accident (MVA) Sept ‘01 Right temporal bone fracture with right

sided paralysis of face

Case 12 History

14 y/o female Fell off the back of a pickup truck going

approx 30 mph Left temporal bone fracture she currently has bleeding from the left

ear canal

Otoscopy

Skin laceration on skin of left external auditory canal

Left TM seems intact but there is evidence of hemotympanum

Case 13 history

21 year old female History of left cholesteatoma with

tympanoplasty, ossicular chain reconstruction and tympanomastoidectomy three months prior

Otoscopy

Right is within normal limits Left shows no retraction pockets and

seems to be healing well

Case 14 History

76 year old female Four months post left canaloplasty,

tympanoplast and ossicular chain reconstruction

Otoscopy

Right is within normal limits Left TM is dull