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Laryngorhinootologie 2019; 98(12): 885-897
DOI: 10.1055/a-0978-8192
Facharztwissen HNO

Aktuelle Aspekte der Cholesteatomchirurgie – Teil 1: Grundlagen und Diagnostik

Current Aspects of Cholesteatoma Surgery – Part 1: Fundamentals and Diagnostics
Anja Schulze
,
Thomas Zahnert
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Das Cholesteatom als chronische Entzündung des Mittelohrs führt zu einer fortschreitenden knöchernen Destruktion des Felsenbeins. Leitsymptome sind fötide Otorrhö, Schwerhörigkeit und Schwindel. Unbehandelt kann das Cholesteatom durch intrakranielle Komplikationen letal verlaufen. Es folgt eine Darstellung des aktuellen und allgemein anerkannten Kenntnisstandes zur Genese, Klinik und präoperativen Diagnostik. Ausführungen zur operativen Therapie folgen in einem 2. Teil.

Abstract

Cholesteatoma is a chronic inflammation of the middle ear, which leads to a progressive bony destruction of the petrous bone. Main symptoms are fetid otorrhea, hearing loss and dizziness. Left untreated, cholesteatoma may be fatal due to intracranial complications. The following overview is intended to illustrate the current and generally recognized knowledge of genesesi, clinical symptoms und preoperative diagnostical procedure. Surgical therapie will be focussed in a second part.

Schlüsselwörter

Cholesteatom - Computertomografie - DWI - HR-CT - Gehörgangscholesteatom - Chirurgie - Felsenbein

Keywords

Cholesteatoma - surgery - DWI - HR-CT - petrous bone destruction


Publication History

Article published online:
06 December 2019

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • Literatur

  • 1 Yung M, Tono T, Olszewska E. et al. EAONO/JOS Joint Consensus Statements on the Definitions, Classification and Staging of Middle Ear Cholesteatoma. J Int Adv Otol 2017; 13 (01) 1-8
    CrossrefPubMedGoogle Scholar
  • 2 Du Verney J. Traité de l‘Organe de l‘Ouie. Paris: 1683
    Google Scholar
  • 3 Cruveilhier J. Anatomie pathologique du corps humain, “Pathological Anatomy of the Human Body”. 2 vol 1829-1842
    PubMedGoogle Scholar
  • 4 Müller J. Über den feineren Bau und die Formen der krankhaften Geschwülste. Berlin: Reimer; 1838
    Google Scholar
  • 5 Soldati D, Mudry A. Knowledge about cholesteatoma, from the first description to the modern histopathology. Otol Neurotol 2001; 22 (06) 723-730
    CrossrefPubMedGoogle Scholar
  • 6 Welkoborsky H. Aktuelle Konzepte zur Pathogenese des erworbenen Cholesteatoms. Laryngorhinootol 2011; 90 (01) 38-51
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Tos M. Incidence, etiology and pathogenesis of cholesteatoma in children. Adv Otorhinolaryngol 1988; 40: 110-117
    PubMedGoogle Scholar
  • 8 Kemppainen HO, Puhakka HJ, Laippala PJ. et al. Epidemiology and aetiology of middle ear cholesteatoma. Acta Otolaryngol 1999; 119 (05) 568-572
    CrossrefPubMedGoogle Scholar
  • 9 Olszewska E, Wagner M, Bernal-Sprekelsen M. et al. Etiopathogenesis of cholesteatoma. Eur Arch Otorhinolaryngol 2004; 261 (01) 6-24
    CrossrefPubMedGoogle Scholar
  • 10 Ratnesar P. Chronic ear disease along the coasts of Labrador and Northern Newfoundland. J Otolaryngol 1976; 5 (02) 122-130
    PubMedGoogle Scholar
  • 11 Louw L. Acquired cholesteatoma pathogenesis: stepwise explanations. J Laryngol Otol 2010; 124 (06) 587-593
    CrossrefPubMedGoogle Scholar
  • 12 Kuo CL, Lien CF, Chu CH, Shiao AS. Otitis media with effusion in children with cleft lip and palate: a narrative review. Int J Ped Otorhinolaryngol 2013; 77 (09) 1403-1409
    CrossrefPubMedGoogle Scholar
  • 13 Spilsbury K, Ha JF, Semmens JB, Lannigan F. Cholesteatoma in cleft lip and palate: a population-based follow-up study of children after ventilation tubes. Laryngoscope 2013; 123 (08) 2024-2029
    CrossrefPubMedGoogle Scholar
  • 14 Strutz J, Mann WJ. Praxis der HNO-Heilkunde, Kopf- und Halschirurgie. Stuttgart: Thieme; 2017
    Google Scholar
  • 15 Sudhoff H, Tos M. Pathogenesis of attic cholesteatoma: clinical and immunohistochemical support for combination of retraction theory and proliferation theory. Am J Otol 2000; 21 (06) 786-792
    PubMedGoogle Scholar
  • 16 Jin BJ, Min HJ, Jeong JH. et al. Expression of EGFR and microvessel density in middle ear cholesteatoma. Clin Exp Otorhinolaryngol 2011; 4 (02) 67-71
    CrossrefPubMedGoogle Scholar
  • 17 Ergün S, Zheng X, Carlsöö B. Expression of transforming growth factor-α and epidermal growth factor receptor in middle ear cholesteatoma. Am J Otol 1996; 17 (03) 393-396
    PubMedGoogle Scholar
  • 18 Linder T, Shah S, Martha AS. et al. Introducing the ChOLE Classification. Otol Neurotol 2019; 40 (01) 63-72
    CrossrefPubMedGoogle Scholar
  • 19 Minovi A, Dazert S. Erkrankungen des Mittelohres im Kindesalter. Laryngorhinootol 2014; 93 S01 1-23
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Hassman-Poznańska E, Kurzyna A, Trzpis K, Poznańska M. The status oft the contralateral ear in children with acquired cholesteatoma. Acta Otolaryngol 2012; 132 (04) 404-408
    CrossrefPubMedGoogle Scholar
  • 21 Muzaffar J, Metcalfe C, Colley S, Coulson C. Diffusion-weighted magnetic resonance imaging for residual and recurrent cholesteatoma: a systematic review and meta-analysis. Clin Otolaryngol 2017; 42 (03) 536-543
    CrossrefPubMedGoogle Scholar
  • 22 Lingam R, Bassett P. A meta-analysis on the diagnostic performance of non-echoplanar diffusion-weighted imaging in detecting middle ear cholesteatoma: 10 years on. Otol Neurotol 2017; 38 (04) 521-528
    CrossrefPubMedGoogle Scholar
  • 23 Cavaliere M, Di Lullo AM, Cantone E. et al. Cholesteatoma vs granulation tissue: a differential diagnosis by DWI-MRI apparent diffusion coefficient. Eur Arch Otorhinolaryngol 2018; 275 (09) 2237-2243
    CrossrefPubMedGoogle Scholar
  • 24 Pirece N, Antonelli P. Effiacy of Antibiotic Prophylaxis…. Laryngoscope 2016; 126 (10) 2363-2366
    CrossrefPubMedGoogle Scholar