| External auditory canal cholesteatoma and keratosis obturans: The role of imaging in preventing facial nerve injury. | |
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MedLine Citation:
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PMID: 22180115 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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We conducted a retrospective study to compare the clinical characteristics of external auditory canal cholesteatoma (EACC) with those of a similar entity, keratosis obturans (KO). We also sought to identify those aspects of each disease that may lead to complications. We identified 6 patients in each group. Imaging studies were reviewed for evidence of bony erosion and the proximity of disease to vital structures. All 6 patients in the EACC group had their diagnosis confirmed by computed tomography (CT), which demonstrated widening of the bony external auditory canal; 4 of these patients had critical erosion of bone adjacent to the facial nerve. Of the 6 patients with KO, only 2 had undergone CT, and neither exhibited any significant bony erosion or expansion; 1 of them developed osteomyelitis of the temporal bone and adjacent temporomandibular joint. Another patient manifested KO as part of a dermatophytid reaction. The essential component of treatment in all cases of EACC was microscopic debridement of the ear canal. We conclude that EACC may produce significant erosion of bone with exposure of vital structures, including the facial nerve. Because of the clinical similarity of EACC to KO, misdiagnosis is possible. Temporal bone imaging should be obtained prior to attempts at debridement of suspected EACC. Increased awareness of these uncommon conditions is warranted to prompt appropriate investigation and prevent iatrogenic complications such as facial nerve injury. |
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Authors:
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Edward D McCoul; Matthew B Hanson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Ear, nose, & throat journal Volume: 90 ISSN: 1942-7522 ISO Abbreviation: Ear Nose Throat J Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7701817 Medline TA: Ear Nose Throat J Country: United States |
Other Details:
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Languages: eng Pagination: E1-7 Citation Subset: IM |
Affiliation:
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ENT and Allergy Associates, LLP (Westchester County), Tuckahoe, NY, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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