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21.01.2014

Cholesteatoma new treatment, sleeplessness meaning - Within Minutes

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Chronic otitis media with cholesteatoma – A persistent hole in the eardrum sometimes can lead to a cholesteatoma, a growth (tumor) in the middle ear made of skin cells and debris. The doctor will ask about a history of ear infections, treatments used, and any previous ear surgery. A cholesteatoma is a benign growth of skin in an abnormal location such as the middle ear or petrous apex.
A perforation of the eardrum occuring because of a chronic infection or direct trauma can lead to a cholesteatoma. Some patients are born with small remnants of skin which become entrapped within the middle ear (congenital cholesteatoma) or petrous apex (petrous apex epidermoid). Complications from untreated cholesteatoma: Erosion of the ossicles or bones behind the eardrum can lead to a conductive hearing loss. In all circumstances, surgery involves general anesthesia and the procedure can last anywhere from one hour to three hours depending on the size of the cholesteatoma and extent of infection. Surgical Outcomes: Whenever surgery is performed for cholesteatoma, there are three possible results of surgery depending on what is found during the operation.
If the cholesteatoma can be removed only in pieces, there is always a chance cholesteatoma fragments left behind may regrow at a later time. If the cholesteatoma is rather extensive and adherent to the inner ear or facial nerve, it may not be possible to remove the entire cholesteatoma and a radical mastoidectomy is performed. TympanoplastyWith a cholesteatoma limited to the tympanic membrane or with a small congenital cholesteatoma or with a limited cholesteatoma forming through an eardrum perforation, the procedure can be done through the ear canal. In order to allow clear visualization of the cholesteatoma, frequently it is necessary to remove the incus bone. TympanomastoidectomyFrequently the mastoid bone located behind the ear must be explored to remove any cholesteatoma that may have spread there through the middle ear. Risks of the surgery include taste disturbance, facial paralysis, recurrence of cholesteatoma, hearing loss and dysequilibrium.


Temporary dysequilibrium can occur from dissection of the cholesteatoma from surrounding structures such as the inner ear and stapes bone. In all circumstances, surgery involves general anesthesia, and the procedure can last one to two hours depending on the size of the cholesteatoma and the extent of infection. Step 3: After partial removal of the mastoid bone, the cholesteatoma near the eardrum and in the mastoid is exposed. Frequently, the mastoid bone located behind the ear must be explored to remove any cholesteatoma that may have spread there through the middle ear. Cholesteatomas actively erode bone because they contain enzymes which are activated by moisture. A (CAT) CT scan is obtained by the ear surgeon to determine how much the cholesteatoma has spread in the ear. Once infection is cleared up and the ear is dry, a decision regarding surgery to remove the cholesteatoma can be made. Unless the person with cholesteatoma is extremely ill with other medical conditions, microsurgery and removal of the cholesteatoma is recommended. The doctor also will want to know about any medications being taken to treat an ear problem, including the type, dose, and length of treatment. If the otolaryngologist suspects mastoiditis or a cholesteatoma, additional tests may be needed.
Antibiotic treatment of the infection causing the chronic otitis media may be enough to stop the ear from draining. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
If the cholesteatoma is small and can be removed entirely in one piece, the eardrum and the ossicles are reconstructed all in one operation. Inner ear trauma leading to temporary dysquilibrium from overmanipulation of the stapes bone while dissecting the cholesteatoma from the surrounding structures can occur.


For this reason patients who have had a cholesteatoma surgically treated and especially those who have had a canal-wall-down procedure require close follow-up to detect early recurrence.
In all other circumstances, surgery is required to help prevent the progression of cholesteatoma and infection. Surgery usually is necessary to correct a persistent eardrum perforation or to remove a cholesteatoma. Cholesteatomas can cause hearing loss and are prone to get infected, which can cause ear drainage. A chronic infection and a cholesteatoma also can cause injury to the facial nerves and facial paralysis. Individuals' particular facts and circumstances will determine the treatment which is most appropriate. Cholesteatomas will grow large enough to erode the middle ear structures and the mastoid bone behind the middle ear.
Occasionally the cholesteatoma may invade this nerve and it may be necessary to resect the nerve anyway.
A radical mastoidectomy is an operation where this bony partition is removed and the eardrum, malleus and incus bones are permanently removed so that the inner lining of the large cholesteatoma sac can be safely cleaned in the office. Gray-colored areas may represent fluid, infection, cholesteatoma or scar from previous surgery.
This operation is done when an extensive cholesteatoma is encountered or one that is adherent to the inner ear or facial nerve.



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