ABSTRACT
Background and Objectives@#To investigate surgical outcomes of revision operation for recurrent cholesteatoma.Subjects and Method From 1989 to 2018, 5245 cases of middle ear surgeries were performed at Kangdong and Hallym University Sacred Heart Hospital. A total of 138 clinical records of the subjects who underwent revision cholesteatoma surgery, and whose follow-up durations were more than 3 months, were reviewed. Hearing outcomes were analyzed in accordance with the 2005 Korean otology society guideline. Postoperative perforation was defined to be present if perforation exists after three months of surgery. Postoperative infection or recurrence was defined if patients were treated with intravenous antibiotics or underwent reoperation. @*Results@#Among 138 cases, surgical approaches used were canal wall up mastoidectomy in 38 (28%), canal wall down mastoidectomy in 89 (64%), and exploratory tympanotomy in 11 (8%). Air conduction and air bone gap showed statistically significant differences before and after the surgery. The number of patients who met at least 1 criteria was 70, accounting for 51%. Patients were classified into four groups according to the Postoperative ABG grade, where 43% of patients were included in “Excellent” or “Good” results group. When the results were compared according to the surgical method, canal wall up group showed significantly higher hearing success rate compared to CWDM group. Patients without postoperative perforation, infection or recurrence were considered successful and there were 122 such cases, accounting for 88%. @*Conclusion@#CWDM more frequently underwent revision than CWUM and ET, and showed worse hearing results than other groups. These analyses can be used for preoperative counseling.
ABSTRACT
Branchial cleft cyst (BCC) is a relatively common congenital malformation in the neck. However, the fourth BCC is very rare and frequently unknown to clinicians. Failure to appropriately recognize this anomaly may result in misdiagnosis, insufficient treatment, and continued recurrence. Even though its rarity, it usually occurs on the left side. Here, we present an unusual case of fourth branchial cleft cyst that occurred on the right side.
ABSTRACT
BACKGROUND AND OBJECTIVES@#Although there are number of studies on the risk factors of recidivism in the congenital middle ear cholesteatoma, few have focused on the staging system. In this study, we aimed to investigate the postoperative recurrence rate in surgical cases of congenital middle ear cholesteatoma, and compare the results of using the Potsic staging system with those of a novel Kim staging system. Additionally, we also studied to see if the Kim staging system could suggest an appropriate surgical approach for each stage.SUBJECTS AND METHOD: Surgical cases of the disease from January, 1989 to August, 2017 performed at Kangdong Sacred Heart or Hallym University Sacred Heart Hospital were included and those data were retrospectively reviewed. All the cases were pre-operatively assigned to the stages using both Potsic and Kim staging system, retrospectively. The post-operative recurrence rate was analyzed for each subject according to the findings of one year after surgery using both staging systems. Additionally, surgical approach performed in these cases, such as mastoidectomy and/or ossiculoplasty were analyzed and compared among the stage groups of Kim staging system.@*RESULTS@#The Potsic staging system showed that recurrence was significantly lower in the stage I than in the other stages, and the Kim staging system showed that recurrence was significantly higher in the revision R stage than in the primary A, P, and M stages. The Kim staging system showed that mastoidectomy was performed more frequently in the M stage, and ossiculoplasty was performed less frequently in the A stage than in the other stages.@*CONCLUSION@#Although Potsic and Kim staging systems were both useful for predicting prognosis, the Kim staging system can additionally provide a clue for an appropriate surgical approach for each stage.