Mastoid subperiosteal abscess as a first sign of unnoticed cholesteatoma in children

[Congenital cholesteatoma of the mastoid process: cases of diagnosis and surgical treatment]

A brief review of the epidemiology and pathogenesis of congenital cholesteatoma (CC) of the temporal bone pyramid is presented, classifications reflecting the degree of spread or localization of the process are considered. Variants of local CCs of the mastoid process don't fit into these classifications, as well as there is no statistics on the frequency of their detection and treatment due to the rarity of this pathology. Clinical cases of diagnosis, surgical treatment of CC of the mastoid process and its results are described. Clinical examples indicate a long-term asymptomatic course of CC of the mastoid process, accompanied by a pronounced destructive process in the mastoid process. Early surgical treatment makes it possible to remove the neoplasm as radically as possible and preserve hearing function.

Congenital cholesteatoma localized to the mastoid cavity and presenting as a mastoid abscess

Introduction. Congenital cholesteatoma is a pearly white mass that rarely originates from the mastoid process. Case Report. A 21-year-old male patient presented to our department with severe right mastoid pain and postauricular fluctuant swelling for 23 days. There was no preceding history of ear complaints and examination showed a normal right ear drum. Emergency exploration of the mastoid process was done on the same day and revealed localized cholesteatoma limited only to the mastoid cavity. Conclusion. Despite a rarity, the mastoid process should be always put in mind as a site of origin for congenital cholesteatoma.

Tympanomastoidectomy for cholesteatoma among Nigerians

The incidence of cholesteatoma among Nigerians is not well documented, as is the outcome of surgical treatment. A descriptive analysis of prospectively collected data of cases of cholesteatoma managed with tympanomastoidectomy at National Hospital Abuja between September 2005 and April 2012 is presented. Cases were analyzed for age, sex, type of cholesteatoma, intra-operative findings, and post-operative outcome after 6 months of follow up. A total of 28 ears from 25 cases of cholesteatoma had tympanomastoidectomy. Age range was 6-73 years (mean = 34.4, SD = 18.67). There were 13 females and 12 males. Primary acquired cholesteatoma was seen in 18 cases (20 ears), secondary acquired in 5 cases (six ears), and external auditory canal cholesteatoma was seen in 2 cases (two ears). The sites involved in middle ear cholesteatoma was attic, sinus and mesotympanum pars tensa (16/26), attic, sinus, antrum and mastoid cavity (5/26), attic, sinus, mesotympanum and mastoid antrum (4/26), and attic only (3/26).21/25 of cases (24 ears) managed had single stage intact canal wall (ICW) tympanomastoidectomy, while 4/25 (4 ears) had two-stage surgery with canal wall down tympanomastoidectomy in two of these, and revision surgery done within 12 months of first surgeries. 2/25 cases (in the two stage revision group) had postoperative persistent mastoid cutaneous fistula and were treated with post-auricular advancement flap. The commonest cholesteatoma type seen at National Hospital Abuja, Nigeria was primary acquired type, and involved the attic, sinus and mesotympanum pars tensa mainly, and most can be managed by single stage tympanomastoidectomy.