Journal Reviews
How reliable is non-echoplanar diffusion-weighted MRI in picking up postoperative cholesteatoma in children?
Cholesteatoma occurs more often in children than in adults and is more aggressive, often resulting in ossicular erosion and marked conductive loss, amongst other more serious possibilities. Recurrence happens in all three methods used, namely canal wall up, canal wall...
Hearing outcomes after mastoid obliteration tympanoplasty
In this study, the authors retrospectively compare hearing outcomes after mastoid obliteration to non-obliterative techniques in cholesteatoma surgery. They have performed canal wall up with mastoid obliteration (bony obliteration tympanoplasty or BOT) since 2013. The procedure has replaced canal wall...
Role of non-echo planar diffusion weighted magnetic resonance imaging in detection of cholesteatoma
Whilst the method of canal wall down and same-session reconstruction is emerging to be more popular, canal wall up procedures are still performed. In either, it is necessary to ensure eradication of cholesteatoma or detect its recurrence. The reliability of...
Management of postoperative cholesteatoma
This prospective longitudinal observational study compared the ability of second-look surgery with that of surveillance using serial non-echo-planar diffusion-weighted imaging to detect residual cholesteatoma after canal wall-up mastoidectomy. A total of 34 patients were included in the study who underwent...
Lateral skull base surgery using the endoscope
Endoscopic lateral skull base surgery could be performed via less invasive techniques due to wide panoramic visualisation of the operative field. With less invasive techniques, patients have been shown to require shorter recovery time and reduced postoperative pain. In this...
Is canal wall down with obliteration a useful compromise between canal wall up procedure and open mastoid cavities?
Controversy has raged for many years between open mastoid cavity procedures and canal wall up techniques in terms of postoperative recidivism and ear discharge. It is generally believed that canal wall up procedures can miss hidden cholesteatoma but preserve useful...
Accuracy of CT scans for cholesteatoma and its complications
Chronic ear disease with cholesteatoma generally requires active surgical management and the requirement for this needs precise assessment. A retrospective study was conducted to evaluate the accuracy of CT scan findings in terms of predicting cholesteatoma and its associated complications...
Differences between paediatric and adult cholesteatomas
An understanding of the differences between adult and paediatric cholesteatomas should be helpful in more effective management of the disease in children. In this study, the authors focused their comparison between paediatric and adult cholesteatomas to the operative findings, rates...
Treating middle ear conditions in developing countries
This month’s journal issue discussed global health in otolaryngology with this paper focusing on the management of chronic middle ear disease in the developing world. Chronic suppurative otitis media (CSOM) is more common in developing countries. The reason for this...
Diagnostic performance of non-echo-planar diffusion weighted MRI in detection of suspected cholesteatoma
Even though a ‘second look’ remains a gold standard for detection of residual cholesteatoma after intact canal wall techniques, non-echo-planar diffusion weighted MRI is considered a reasonable alternative to avoid further surgery. However, to establish or exclude a cholesteatoma de...
Options for the endoscope and acquired cholesteatoma
This was a thought-provoking article examining the reasons why the authors believe that the endoscope is enabling an improved understanding of acquired cholesteatoma and its management. They describe in depth the ventilation pathways of the middle ear, and how they...
Evidence based outcomes for canal wall up, canal wall down and subsequent canal wall reconstruction for primary cholesteatoma
There has been a long standing controversy over whether to treat primary cholesteatoma with open or closed technique. The general consensus is that limited disease can be treated with closed technique whereas the canal wall down approach helps reduce recidivism...
