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Massive temporal lobe cholesteatoma.

Waidyasekara P, Dowthwaite SA, Stephenson E, Bhuta S, McMonagle B - Case Rep Otolaryngol (2015)

Bottom Line: The patient made an uneventful recovery and remains well over 12 months later.Conclusion.There was a completely asymptomatic progression of disease until several weeks prior to this presentation.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD 4215, Australia.

ABSTRACT
Introduction. Intracranial extension of cholesteatoma is rare. This may occur de novo or recur some time later either contiguous with or separate to the site of the original cholesteatoma. Presentation of Case. A 63-year-old female presented to a tertiary referral hospital with a fluctuating level of consciousness, fever, headache, and right-sided otorrhoea, progressing over several days. Her past medical history included surgery for right ear cholesteatoma and drainage of intracranial abscess 23 years priorly. There had been no relevant symptoms in the interim until 6 weeks prior to this presentation. Imaging demonstrated a large right temporal lobe mass contiguous with the middle ear and mastoid cavity with features consistent with cholesteatoma. The patient underwent a combined transmastoid/middle fossa approach for removal of the cholesteatoma and repair of the tegmen dehiscence. The patient made an uneventful recovery and remains well over 12 months later. Conclusion. This case presentation details a large intracranial cholesteatoma which had extended through a tegmen tympani dehiscence from recurrent right ear cholesteatoma treated by modified radical mastoidectomy over two decades priorly. There was a completely asymptomatic progression of disease until several weeks prior to this presentation.

No MeSH data available.


Related in: MedlinePlus

(a) High resolution CT axial image at the level of the lateral semicircular canal demonstrates a fluid filled mastoid cavity, partial erosion of incus, and an intact anterior epitympanic air cell partitioned by the cog. (b) High resolution coronal CT of right temporal bone demonstrating an approximate 9 mm defect involving the superiomedial external ear canal and tegmen mastoideum.
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fig1: (a) High resolution CT axial image at the level of the lateral semicircular canal demonstrates a fluid filled mastoid cavity, partial erosion of incus, and an intact anterior epitympanic air cell partitioned by the cog. (b) High resolution coronal CT of right temporal bone demonstrating an approximate 9 mm defect involving the superiomedial external ear canal and tegmen mastoideum.

Mentions: High-resolution CT of the temporal bones demonstrated opacification of the right mastoid cavity with ossicular chain erosion (Figure 1(a)). A 9 mm bony defect of the tegmen tympani was evident (Figure 1(b)). T2-weighted axial MRI scans showed a well demarcated heterogeneous mass approximately 55 mm × 48 mm centred within the right temporal lobe extending from the right tegmen defect with cytotoxic oedema of the surrounding brain tissue (Figures 2(a) and 2(b)).


Massive temporal lobe cholesteatoma.

Waidyasekara P, Dowthwaite SA, Stephenson E, Bhuta S, McMonagle B - Case Rep Otolaryngol (2015)

(a) High resolution CT axial image at the level of the lateral semicircular canal demonstrates a fluid filled mastoid cavity, partial erosion of incus, and an intact anterior epitympanic air cell partitioned by the cog. (b) High resolution coronal CT of right temporal bone demonstrating an approximate 9 mm defect involving the superiomedial external ear canal and tegmen mastoideum.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4364359&req=5

fig1: (a) High resolution CT axial image at the level of the lateral semicircular canal demonstrates a fluid filled mastoid cavity, partial erosion of incus, and an intact anterior epitympanic air cell partitioned by the cog. (b) High resolution coronal CT of right temporal bone demonstrating an approximate 9 mm defect involving the superiomedial external ear canal and tegmen mastoideum.
Mentions: High-resolution CT of the temporal bones demonstrated opacification of the right mastoid cavity with ossicular chain erosion (Figure 1(a)). A 9 mm bony defect of the tegmen tympani was evident (Figure 1(b)). T2-weighted axial MRI scans showed a well demarcated heterogeneous mass approximately 55 mm × 48 mm centred within the right temporal lobe extending from the right tegmen defect with cytotoxic oedema of the surrounding brain tissue (Figures 2(a) and 2(b)).

Bottom Line: The patient made an uneventful recovery and remains well over 12 months later.Conclusion.There was a completely asymptomatic progression of disease until several weeks prior to this presentation.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD 4215, Australia.

ABSTRACT
Introduction. Intracranial extension of cholesteatoma is rare. This may occur de novo or recur some time later either contiguous with or separate to the site of the original cholesteatoma. Presentation of Case. A 63-year-old female presented to a tertiary referral hospital with a fluctuating level of consciousness, fever, headache, and right-sided otorrhoea, progressing over several days. Her past medical history included surgery for right ear cholesteatoma and drainage of intracranial abscess 23 years priorly. There had been no relevant symptoms in the interim until 6 weeks prior to this presentation. Imaging demonstrated a large right temporal lobe mass contiguous with the middle ear and mastoid cavity with features consistent with cholesteatoma. The patient underwent a combined transmastoid/middle fossa approach for removal of the cholesteatoma and repair of the tegmen dehiscence. The patient made an uneventful recovery and remains well over 12 months later. Conclusion. This case presentation details a large intracranial cholesteatoma which had extended through a tegmen tympani dehiscence from recurrent right ear cholesteatoma treated by modified radical mastoidectomy over two decades priorly. There was a completely asymptomatic progression of disease until several weeks prior to this presentation.

No MeSH data available.


Related in: MedlinePlus