Iatrogenic cholesteatoma.We evaluated a 12-year-old boy who had undergone a myringoplasty 1 year earlier. At that time, he had had a large posterior perforation per·fo·ra·tion n. 1. The act of perforating or the state of being perforated. 2. An abnormal opening in a hollow organ or viscus, as one made by rupture or injury. Perforation A hole. of the tympanic membrane on the right. The ossicular os·si·cle n. A small bone, especially one of the three bones of the middle ear. [Latin ossiculum, diminutive of os, bone; see ost- in Indo-European roots. chain was intact. An overlay technique was used to place a temporalis fascia graft over the malleus malleus /mal·le·us/ (mal´e-us) [L.] the outermost of the auditory ossicles, and the one attached to the tympanic membrane; its club-shaped head articulates with the incus mal·le·us n. pl. handle and posterior annulus annulus /an·nu·lus/ (an´u-lus) pl. an´nuli [L.] anulus. an·nu·lus or an·u·lus n. pl. an·nu·lus·es or an·nu·li A circular or ring-shaped structure. , and the boy's hearing returned to normal. At the 1-year follow-up, a pearly-white spherical mass 3 nun in diameter was seen in the posteroinferior quadrant behind a translucent drum (figure, A). The anterior part of the tympanic membrane was infiltrated with plaques of tympanosclerosis that had probably been present before the myringoplasty. The lesion was diagnosed as an epithelial cyst cyst, abnormal sac in the body, filled with a fluid or semisolid and enclosed in a membrane. Cysts can be congenital but are usually acquired, the most common locations being the skin and the ovaries. that had developed from epithelial fragments that had been left in place under the graft, possibly because of an improper surgical technique (although such a lesion can occur under the care of the most experienced surgeon). The encapsulated cyst was removed by raising a tympanomeatal flap (figure, B). The patient was advised to return for an annual follow-up for the next 3 years. [FIGURE OMITTED] From the Pulec Ear Clinic, Los Angeles (Dr. Pulec), and Gap, France (Dr. Deguine). Jack L. Pulec, MD ([dagger]) Christian Deguine, MD ([dagger]) The late Dr. Pulec was editor-in-chief of EAR NOSE & THROAT JOURNAL from 1992 through 2003. |
|
||||||||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion