A Case of Secondary Cholesteatoma Extending to the Dura Mater of the Middle Cranial Fossa

DOI Web Site 参考文献1件

抄録

Secondary cholesteatoma is relatively rare, but can develop by extension of the tympanic epithelium into the tympanic cavity through perforation of the marginal membrane. The subject reported herein was a 68-year-old male patient with a history of persistent bilateral otorrhea since childhood. Examination revealed a large perforation in the tympanic membrane on both sides, with debris observed on the promontory of the right tympanic cavity. The hearing level was 66.7 dB in the right ear, and 65 dB in the left ear. Subsequently, a secondary cholesteatoma, with the cholesteatoma matrix extending continuously from the upper edge of the tympanic membrane perforation was observed, a tympanoplasty was attempted under general anesthesia on the right side. Among the ossicles, only the stapedial footplate and the handle of the malleus were found to remain, and the horizontal portion of the facial nerve canal was also broadly destroyed. While the antrum mastoideum was filled by the cholesteatoma extending from the tympanic cavity, the cholesteatoma matrix and the dura mater of the middle cranial fossa were tightly adherent and very difficult to separate. Therefore, the plasty method, referred to as the “open method tympanoplasty”, was employed, allowing the cholesteatoma matrix in the mastoid antrum to remain. Until now, five years after the surgery, no recurrence has been observed. Thus, in patients with chronic otitis media associated with tympanic perforation and pesistent otorrhea in whom the perforation is found to extend to the handle of the malleus, the possibility of a secondary cholesteatoma should be borne in mind. In such cases, rather than continuing with conservative treatment, it is important to examine the patient carefully, bearing in mind the possibility of secondary cholesteatoma.

収録刊行物

参考文献 (1)*注記

もっと見る

キーワード

詳細情報 詳細情報について

問題の指摘

ページトップへ