Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T08:11:24.900Z Has data issue: false hasContentIssue false

Analysis of surgical treatment for middle-ear cholesterol granuloma

Published online by Cambridge University Press:  22 May 2009

Y Matsuda*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
T Kurita
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
Y Ueda
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
S Ito
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
T Nakashima
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
*
Address for correspondence: Dr Yoichi Matsuda, Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. Fax: +81 942 37 1200 E-mail: [email protected]

Abstract

Cholesterol granuloma is an intractable ear disease. Many studies of this condition have been published since the initial report by Manasse. However, the pathogenesis of this condition is unclear. This study reviewed the treatment of middle-ear cholesterol granuloma in 16 patients undergoing surgical treatment at Kurume University Hospital.

The relationship between patients' pre-operative tympanic membrane findings and post-operative course was analysed. Patients with swollen tympanic membranes had significantly poorer outcomes. Patients with retracted tympanic membranes and those undergoing ossicular chain reconstruction had significantly better outcomes. The patients' overall hearing success rate at approximately two weeks post-operatively was 75 per cent. However, by six months post-operatively, the overall hearing success rate had declined to 62.5 per cent. Patients with poor hearing two weeks post-operatively did not acquire better hearing.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Manasse, P. “Die Ohrenheilknude der Genenwart und ihre Grenzgebiete [in German]. Handbuch der Pathologischen Anatomie des Menschlichen Ohres 1917;9:55Google Scholar
2Shambaugh, GE. The blue membrane. Arch Otolaryngol 1929;10:238–49CrossRefGoogle Scholar
3Paparella, MM, Lim, DJ. Pathogenesis and pathology of the idiopathic blue ear drum. Arch Otolaryngol 1967;85:249–58CrossRefGoogle ScholarPubMed
4Sheehy, JL, Linthicum, FH Jr, Greenfield, EC. Chronic serous mastoiditis, idiopathic hematotympanum and cholesterol granuloma of the mastoid. Laryngoscope 1969;79:1189–217CrossRefGoogle Scholar
5Friedmann, I. Epidermoid cholesteatoma and granuloma. Ann Otol Rhinol Laryngol 1959;68:5979CrossRefGoogle ScholarPubMed
6Urano, M, Nakano, Y, Ikarashi, F. Pathogenesis of cholesterol granuloma – electron microscopic studies of the mastoid air cell system. Otol Jpn 1996;6:1419Google Scholar
7Ikeda, M, Watanabe, I, Katsura, Y, Eguchi, T, Sakamoto, Y, Yorita, M. Surgical treatment of cholesterol granuloma [in Japanese]. Saitama Igakukai Zasshi 1998;32:773–8Google Scholar
8Ikeda, M, Watanabe, I. Post-operative evaluation of cholesterol granuloma. Ear Res Jpn 1997;90:881–8Google Scholar
9Farrior, B, Kampsen, E, Farrior, JB. The positive pressure of cholesterol granuloma idiopathic blue ear drum. Different diagnosis. Laryngoscope 1981;91:1286–95CrossRefGoogle Scholar
10Plester, D. Cholesterol, granuloma. Otolaryngol Clin North Am 1982;15:665–72CrossRefGoogle Scholar
11Inagi, K, Shitara, T, Okamoto, M, Sano, H. Hearing impairment in cases of chronic middle ear inflammation with cholesterol granuloma. Ear Res Jpn 1990;17:3946Google Scholar
12Nakano, Y. Cholesterol, granuloma. Pract Otol 1990;83:1761–6CrossRefGoogle Scholar
13Komune, S, Taira, T, Uemura, T. Treatment of blue eardrum-idiopathic cholesterol granuloma. Otologia Fukuoka 1991;37:531–4Google Scholar
14Morimitsu, T. Cholesterol granuloma. Nippon Jibiinkoka Gakkai Kaiho (Tokyo) 1993;96:854–7Google Scholar
15Okamoto, M, Matsuoka, A, Inagi, K, Sano, H, Shitara, T. Treatment for cholesterol granuloma of middle ear. Otol Jpn 1995;5:568–73Google Scholar
16Kudoh, F, Shibuya, M. Clinical study of secretory otitis media with cholesterol crystal. Otol Jpn 1993;3:315–20Google Scholar
17Yoshida, S, Tomita, H. The surgical indications and hearing prognosis of middle ear cholesterol granuloma with blue ear drums. Otol Jpn 1994;4:172–6Google Scholar
18Tokio, Sakurai. CT scan findings in blue ear drum. Acta Otolaryngol 1987;435:117–21Google Scholar
19Takahashi, H, Honjo, I, Kurata, K, Fujita, A. A new treatment for middle ear cholesterol granuloma. Pract Otol 1995;8:863–6CrossRefGoogle Scholar
20Takahashi, H, Honjo, I, Kurata, K, Sugimaru, T. Steroid and tube insertion for cholesterol granuloma. A preliminary study. In: Lim, DJ, Bluestone, CD, Casselbrant, ML, eds. Recent Advance in Otitis Media. Proceedings of the Sixth International Symposium, Hamilton (ON): BC Decker, 1997;414–16Google Scholar
21Inagi, K, Shitara, T, Okamoto, M, Sano, H. Clinical study of cholesterol granuloma of middle-ear. Ear Res Jpn 1989;16:613Google Scholar
22Mori, H, Iwanaga, M, Nakamura, H, Yui, M, Ishida, Y. Observation on 122 cases of cholesterol granuloma in otitis media. Pract Otol 1988;81:657–62CrossRefGoogle Scholar
23Inagi, K, Shitara, T, Okamoto, M, Sano, H, Matsuoka, A. Cholesterol granuloma. Ear Res Jpn 1990;17:208Google Scholar