Abstract Objective: To compare the incidence and the histopathological aspect of spontaneous and two induced Mongolian gerbils’ models of cholesteatoma: External Auditory Canal (EAC) obliteration model and the Auditory Tube (AT) cauterization model. Methods: Fifty-four ears of 27 animals were divided into EAC obliteration, AT cauterization, and control groups and histologically assessed for cholesteatoma incidence and classification at intervals of 2, 4, 8, and 16 weeks. Results: Cholesteatoma was diagnosed in 30 of the 53 ears evaluated with a significantly higher incidence in groups that received some type of intervention (p < 0.0001). It was not possible to histologically distinguish cholesteatomas of the same stage between the study groups. Conclusion: Although we observed a significant increase in cholesteatoma incidence with the two methods used when compared to the control group, all developed cholesteatomas were apparently identical from a histological point of view.

Abstract Introduction The treatment of cholesteatoma is generally surgical, and the major obstacle is the high prevalence of recidivism. The endoscopic ear surgery technique is proposed to minimize this problem. Objectives To utilize endoscopes to visualize and manipulate cholesteatoma residues after microscopic removal Methods Cross-sectional study. Thirty-two patients with cholesteatoma underwent microscopic wall-up mastoidectomy combined with the endoscopic approach. The subjects were assessed for the presence and location of covert disease. Results Of the 32 cases, 17 (53.12%) had residual cholesteatoma in the endoscopic phase. Minimal disease was found, usually fragments of the cholesteatoma matrix. Pars tensa cholesteatomas had more covert disease than pars flaccida cholesteatomas (62.50% vs 43.75%). Posterior recesses (47.05%) and tegmen tympani (41.17%) were the locations with more covert disease (p< 0.05). Conclusion Cholesteatomas of the pars tensa presented more residual disease and were significantly more common in the posterior recesses and tegmen tympani.

Resumo Introdução: Colesteatoma é uma lesão destrutiva que pode levar a complicações potencialmente letais. Tipicamente, apresenta hipoacusia e otorreia contínua como sintomas. Por ser uma doença rara, existem poucos estudos no Brasil que descrevam as características destes pacientes. Objetivo: O presente estudo teve como objetivos determinar a prevalência de colesteatoma entre os pacientes com otite média crônica (OMC) e descrever as características clínicas, audiológicas e cirúrgicas dos pacientes com colesteatoma adquirido de orelha média atendidos em um hospital de referência do sistema público de saúde. Método: Estudo transversal e de coorte prospectivo, incluindo 1.710 pacientes com OMC, atendidos entre agosto de 2000 e junho de 2015, sem tratamento cirúrgico prévio. Foram feitas anamnese detalhada, videotoscopia e audiometria, além de revisão de prontuários para busca de dados cirúrgicos. Os colesteatomas foram classificados conforme sua via de formação. Resultados: Dos pacientes com otite média crônica, 419 (24,5%) apresentavam colesteatoma. Média de 34,49 anos; 53,5% do sexo feminino e 63,8% adultos. Colesteatoma foi observado bilateralmente em 17,1%. Os epitimpânicos anteriores corresponderam a 1,9%; os epitimpânicos posteriores a 32,9%; os mesotimpânicos posteriores a 33,7%; duas vias a 14,8% e indeterminados a 16,7%. A média tritonal dos gaps aeroósseos foi de 29,84 dB e não diferiu entre os grupos segundo as vias de formação. Não foram observadas correlações entre tamanho do gap e idade do paciente ou duração dos sintomas. Dos pacientes operados, 16,8% foram submetidos a timpanomastoidectomia fechada e 75,2% a timpanomastoidectomia aberta. Conclusão: A prevalência de colesteatoma em pacientes com otite média crônica foi de 24,5% e foi mais frequente em adultos do que em crianças. Os mesotimpânicos posteriores foram mais frequentes, não foi observada diferença na média dos gaps aeroósseos entre diferentes vias de formação. Nos pacientes submetidos a cirurgia, a timpanomastoidectomia aberta foi o procedimento escolhido.

Abstract Introduction: Cholesteatoma is a destructive lesion that can result in life-threatening complications. Typically, it presents with hypoacusis and continuous otorrhea as symptoms. Because it is a rare disease, there are few studies in Brazil describing the characteristics of patients with the disease. Objective: This study aimed to determine the prevalence of cholesteatoma in patients with chronic otitis media and describe clinical, audiological and surgical characteristics of patients with acquired middle ear cholesteatoma treated at a referral hospital in the public health system. Methods: Cross-sectional and prospective cohort study, including 1710 patients with chronic otitis media, treated between August 2000 and June 2015, without prior surgery. Detailed clinical history, videotoscopy, and audiometry were performed, in addition to review of medical records to search for surgical data. Cholesteatomas were classified according to their route of formation. Results: Of the patients with chronic otitis media, 419 (24.5%) had cholesteatoma; mean age of 34.49 years; 53.5% female and 63.8% adults. Bilateral cholesteatoma was observed in 17.1%. Anterior epitympanic cholesteatoma corresponded to 1.9%; posterior epitympanic, 32.9%; posterior mesotympanic, 33.7%; two routes, 14.8%; and indeterminate, 16.7%. The mean air-bone gap was 29.84 dB and did not differ between routes of formation. There were no correlations between gap size and patient age or duration of symptoms. Of the surgical cases, 16.8% underwent closed tympanomastoidectomy and 75.2% open tympanomastoidectomy. Conclusion: The prevalence of cholesteatoma in patients with chronic otitis media was 24.5% and it was more common in adults than in children. Posterior mesotympanic cholesteatoma was more frequent, with no difference in mean air-bone gap between the different routes of formation. In patients undergoing surgery, open tympanomastoidectomy was the procedure most frequently chosen.

Alguns estudos indicam uma tendência à bilateralidade da otite média crônica. Acredita-se que a orelha contralateral possa fornecer evidências da via de formação da doença da orelha mais afetada, ser um parâmetro da função da tuba auditiva e predizer o sucesso do tratamento. A tomografia computadorizada é um excelente teste para avaliar as estruturas do osso temporal e as alterações decorrentes da da otite média. OBJETIVO: Avaliar tomografias computadorizadas (TC) de osso temporal de pacientes com otite média crônica e descrever anormalidades na orelha contralateral. MÉTODO: Estudo de Prevalências (transversal). Avaliação das TC de 75 pacientes com otite média crônica de um hospital terciário de referência no Brasil por um neurorradiologista. RESULTADOS: A população foi constituída por 50,6% do sexo masculino, com idade média de 36 anos. Encontramos 54,7% de alterações na orelha contralateral claramente relacionadas com otite média crônica. DISCUSSÃO: A prevalência de alterações radiográficas nas orelhas contralaterais de pacientes com otite média crônica corrobora com estudos clínicos, histopatológicos e funcionais desenvolvidos pelo mesmo grupo de pesquisa e sugere que esta doença tem uma característica bilateral.

Some studies indicate a bilateral tendency of chronic otitis media. It is believed that the contralateral ear can provide evidences of the route of formation of ear disease in the most affected, be a parameter of Eustachian tube function and predict successful treatment. The CT scan is an excellent test to evaluate the structures of the temporal bone and the changes resulting from otitis media. OBJECTIVE: To evaluate Temporal Bone Computed Tomography of patients with chronic otitis media and describe abnormalities in the contralateral ear. METHOD: Cross-sectional study. Evaluation of CT scans of 75 patients with chronic otitis media from a tertiary referral hospital in Brazil by a neuroradiologist. RESULTS: Population was consisted of 50.6% males with a mean age of 36 years. We found 54.7% of changes in contralateral ear clearly associated with chronic otitis media. CONCLUSION: The prevalence of radiographic changes in the contralateral ears of patients with chronic otitis media corroborates with clinical, histopathological and functional resources developed by the same group that this disease has a bilateral feature.