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Robot-Assisted Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma
Published on: December 15, 2023
[Cranioencephalic complications of middle ear cholesteatoma: report of 4 cases]
1Clinique ORL et de Chirurgie Cervico-Faciale du Centre Hospitalo-Universitaire de Dakar. a_tall2001@yahoo.fr
Introduction:
Cranial and intracranial complications can be observed during middle ear cholesteatoma's evolution. We report our experience of management of infectious cholesteatoma's cranioencephalic complications.
Material And Methods:
In a three year period, we had consecutively admitted 4 patients with cranioencephalic complications of middle ear cholesteatoma, in the Ear Nose and Throat (ENT) department of the university teaching hospital of Dakar. After preoperative investigations with computed tomography scan (CT scan) of brain and temporal bone. The patients had been operated after paraclinic assessment.
Results:
The finding showed one case of temporal bone otogenic extensive osteomyelitis with multifocal extradural empyema, 3 cases of brain abscess associated with subdural empyema and meningitis in 1 case. For 3 patients (75%), neurosurgical drainage and mastoidectomy were performed, associated with antibiotic treatment. The mastaidectomy was performed in the same time of the surgical procedure or delayed. One patient, with brain abscess, died before surgical intervention. With a follow up of 15 months, we have noticed stable mastoidectomies cavities and no neurological recurrence symptoms.
Conclusion:
These complications can be prevented by early treatment of chronic otitis media diseases. The appropriated management of these complications necessitate collaboration between otorhinolaryngologists and neuro surgeons.
Insights
Early treatment of chronic otitis media prevents serious complications. Management of cranioencephalic complications from cholesteatoma requires collaboration between ENT and neurosurgery specialists.
Area of Science:
- Otolaryngology
- Neurosurgery
- Infectious Diseases
Context:
- Middle ear cholesteatoma can lead to severe cranial and intracranial complications.
- This study focuses on the management of these rare but serious infectious complications.
Purpose:
- To report the experience of managing cranioencephalic complications arising from middle ear cholesteatoma.
- To highlight the clinical presentation, management strategies, and outcomes.
Summary:
- Four patients with cranioencephalic complications of middle ear cholesteatoma were treated over three years.
- Complications included osteomyelitis, extradural empyema, brain abscess, subdural empyema, and meningitis.
- Treatment involved mastoidectomy, neurosurgical drainage, and antibiotics, with one mortality before intervention.
Impact:
- Effective management necessitates multidisciplinary collaboration between otorhinolaryngologists and neurosurgeons.
- Early treatment of chronic otitis media is crucial for preventing these severe complications.
- Surgical intervention and antibiotics showed positive outcomes in survivors with stable cavities and no recurrence.
