Haghjoo Sharifeh, Mousavi Sayed Hamid, Farsi Yeganeh, Nasery Ali Ahmad Makarem, Negin Fawzia, Qaderi Shohra
Department of Medical Informatics, Faculty of Medicine, Kabul University of Medical Sciences, Kabul, Afghanistan.
Medical Research Center, Kateb University, Kabul, Afghanistan; Afghanistan National Charity Organization for Special Diseases (ANCOSD), Kabul, Afghanistan.
Int J Surg Case Rep. 2021 May;82:105916. doi: 10.1016/j.ijscr.2021.105916. Epub 2021 Apr 28.
Cholesteatoma is a benign tumoral lesion of squamous epithelial cells in middle ear that can exist as congenital or acquired forms.
A 35-year-old housewife presented to ENT clinic of a private hospital in Kabul, Afghanistan, with a complete facial nerve paralysis in the right side. In her antecedents, there is a tympanomastoidectomy due to chronic middle ear infection. First symptom was right side earache without any discharge. She started to notice a progressive nodule in the posterior-inferior side of her right ear. The patient was taken to the operating room. She underwent general anesthesia, an extensive cholesteatoma was removed, and a limited area of the fallopian canal in which facial nerve oedema or redness was evident. Post-operative House Brackmann grade was 1 on day 15 after the surgery.
Cholesteatoma is primarily managed surgically and currently there is no suitable medical substitute treatment strategy for cholesteatoma. Hearing improvement, making the ear dry and total omission of cholesteatoma are primary goals of surgical interventions in cholesteatoma management.
Cholesteatoma after surgical manipulations of middle ear is a rare complication with notable morbidity that has been reported almost from all around the world but our patient is the first reported case of cholesteatoma formation after surgical management of COM from Afghanistan that presented with facial nerve paralysis and hear decline.
胆脂瘤是中耳鳞状上皮细胞的一种良性肿瘤性病变，可分为先天性或后天性。
一名35岁的家庭主妇前往阿富汗喀布尔一家私立医院的耳鼻喉科诊所就诊，她右侧面部完全性面瘫。既往有因慢性中耳感染行鼓室乳突切除术史。首发症状为右侧耳痛，无任何分泌物。她开始注意到右耳后下侧有一个逐渐增大的结节。患者被送往手术室。她接受了全身麻醉，切除了广泛的胆脂瘤，并且发现面神经管的一个有限区域有明显的水肿或发红。术后第15天House Brackmann分级为1级。
胆脂瘤主要通过手术治疗，目前尚无适用于胆脂瘤的合适药物替代治疗策略。听力改善、使耳部干燥以及完全清除胆脂瘤是胆脂瘤治疗中手术干预的主要目标。
中耳手术后发生胆脂瘤是一种罕见的并发症，发病率较高，世界各地几乎都有报道，但我们的患者是阿富汗首例报道的慢性化脓性中耳炎手术治疗后出现胆脂瘤形成并伴有面神经麻痹和听力下降的病例。
