Giant cholesteatoma: case and literature review' report

• Main Authors: Nunes, Leonardo Mendes Acatauassú, Barros, Adriano Liberman Magalhães de, Cal, Renato Valério Rodrigues, Nunes, Claudio Tobias Acatauassú, Lima, Fabrício Diniz de
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2010-03-01
• Series: International Archives of Otorhinolaryngology
• Subjects: Cholesteatoma; Cases Report; Review' Literature
• Online Access: http://www.arquivosdeorl.org.br/conteudo/acervo_eng.asp?id=675

Introduction: Cholesteatomas are cystic lesions encased by stratified squamous epithelium, filled for keratin. They are classified in congenital, about of 2-5% and acquired, which are subdivided in primary formed from a tympanic retraction and secondary, originated from epithelium migration through a tympanic perforation. They are tumeurs with an expansive capacity and of bone lysis being able to invade adjacent structures. Case Report: This work reports the case of ONV, 23 years old from Macapá/Amapá. In august 2007, he/she appeared to attendance with a case history of right chronic otorrhea, he/she also reported meningitis and progressive right peripherica facial paralysis. The mastoid tomography demonstrated an hypodense image with density of soft tissues filling the middle ear, destructing the ossicular chain, semicircular canals, cochlea and extending until next to the proximal portion of the internal auditory meatus. He/she was referred to surgery. During the trans-operative it is evidenced an extensive destruction of the cortical layer of the mastoid, which was obstructed by a mass of an yellow coloration, fetid and of the consistent aspect. After the lesion is removed it is verified the presence of fistulae of high debit with posterior fossa. It was proceeded with the fistulae closing with a bone wax and temporal muscle shred. The patient remained confined during 15 days in use wide antimicrobial schema. Currently, it is find in regular accompaniment and in a good general state. Final Comments: This work aims to call attention to the rigorous complications of these pathologies , which despite to be common and to be a benign tumoral lesion can bring severe sequelae to the patient, in the event of the diagnosis and treatment not to be prematurely performed.