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A Unified Classification of Middle Ear and Petrous Bone Congenital Cholesteatomas
Vijayendra Honnurappa1, Nilesh Mahajan1, Vinay Kumar Kumar Vijayendra1
1Vijaya ENT Care Centre, Superspeciality Otology Centre, Bangalore, India.
Background:
The aim of this study was to classify congenital cholesteatoma along an entire spectrum of involvement ranging from the middle ear to petrous apex.
Methods:
A total of 131 patients (85 adults and 46 children) underwent operations for congenital cholesteatoma over the duration of 27 years.
Results:
For most cases, middle ear mucosa was normal, the first ossicle eroded by the mass was the stapes, and the mastoid air cell system was well-pneumatized on intraoperative and radiographic views. Totally 34% of patients presented with facial nerve weakness and 45% of these cholesteatomas arose from the supralabyrinthine area (32.8%) and from the petrous apex (12.2%).
Conclusion:
In this unified classification system, the otologist sees congenital cholesteatoma as a continuum, with facial nerve involvement and anacusis as part of the picture. This system of congenital cholesteatoma accommodates the supralabyrinthine and petrous bone locations of the disease.
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