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The aim of this study was to retrospectively analyze the clinical data of 16 patients with cavernous sinus cholesteatomas, explore the surgical outcomes, and summarize the surgical experience. Patients with cavernous sinus cholesteatomas underwent surgery between June 2016 and June 2022 at the Department of Neurosurgery at the First Affiliated Hospital of Soochow University. Clinical data were obtained from all patients for analysis. Common preoperative symptoms included headache, dizziness, diplopia, ptosis, and facial numbness. There were 7 patients with 2 or more symptoms. There were 13 patients with total resection and 3 patients with subtotal resection. There were 5 patients with improved postoperative symptoms, 10 patients with no significant change, and 1 patient with worse symptoms. New postoperative cranial nerve defects occurred in 4 patients. During the follow-up, all patients had favorable prognosis without progression. Using "double-scope" technique, the subtemporal approach, a surgical strategy for cavernous sinus cholesteatomas, was sufficient to completely resect the tumors. [ABSTRACT FROM AUTHOR]

Cholesterinic granulomas are mass‐like lesions that form at the choroid plexus of the ventricular system. Large cholesterinic granulomas within the lateral ventricles have been reported to cause severe neurological signs. However, little data are available about their prevalence or appearance in the overall population. The objective was to report the prevalence of presumed cholesterinic granulomas on CT in a population of horses, and investigate associations between presumed cholesterinic granuloma presence, lateral ventricle size, age, and neurological signs. The study was cross sectional, CT scans of the head were assessed for presumed cholesterinic granuloma presence and size, and lateral ventricle height. Computed tomography findings and clinical information were compared using nonparametric testing. Computed tomography scans of 139 horses were included. Presumed cholesterinic granulomas were found in 22 horses (15.8%), nine were unilateral and 13 bilateral. A significant increase in prevalence was observed with age (P <.0001), with 38% of horses over 15 years old affected. The median volume of presumed cholesterinic granulomas was 242 mm3 with a range from 51 to 2420 mm3. The mean lateral ventricle height was significantly increased in horses with presumed cholesterinic granulomas present (P =.004), with a median of 7.3 mm compared to 4.9 mm without. Neurological signs were not associated with presumed cholesterinic granuloma presence or lateral ventricle height. Fourth ventricle mineralizations were found in seven horses, which may represent cholesterinic granulomas. In conclusion, presumed cholesterinic granulomas occurred in a large proportion of the examined population and are associated with increased lateral ventricle dilation and advanced age. [ABSTRACT FROM AUTHOR]

Cholesteatomas are cystic lesions which may be either congenital or acquired, affecting the ears and presenting typical imaging patterns at computed tomography because of its expansile nature and tendency to erode bone. However, particularly in cases of lesion residue or recurrence after surgery, the distinction between cholesteatoma and inflammatory tissue based solely on computed tomography findings may be quite difficult, if not impossible. Magnetic resonance imaging might be very useful, particularly in such a context, since delayed postcontrast and diffusion-weighted images can demonstrate different imaging patterns in these two situations. Artifacts related to air-bone interface in the mastoid region may represent a relevant limitation to the utilization of echo-planar diffusion-weighted imaging. Non-echo-planar diffusion-weighted imaging represents an alternative to resolve this problem, once this method is less subject to this type of artifact, besides offering images with higher spatial resolution and thinner slice thickness, allowing the detection of small-sized cholesteatomas. [ABSTRACT FROM AUTHOR]

The records of 190 adults who presented over a 10-year period with previously untreated aural cholesteatomas were analyzed with respect to age, mode of presentation at the level of the tympanic membrane, and pneumatization of the mastoid. The findings were compared with those obtained in an earlier study of 109 children (aged 13 years and younger) seen over the same period of time. Two main types of cholesteatomas were found in both adults and children, most of them (82.3%) associated with sclerotic or diploic mastoids (i.e., poorly pneumatized mastoids) and the rest (17.3%) with pneumatized mastoids. The former type was found more often in adults (96.3%) than in children (57.8%), while the latter was more frequent in children (42.2% as compared to 3.7% in adults). In both adults and children, cholesteatomas associated with poorly pneumatized mastoids showed mainly an attic and mastoid distribution communicating with a pars tensa or pars flaccida retraction or marginal perforation. Cholesteatomas associated with pneumatized mastoids appeared most often behind an intact drum (the so-called congenital cholesteatomas) and were distributed mainly in the tympanic cavity. [ABSTRACT FROM AUTHOR]

Since a heavy cellular infiltrate is seen in the stroma of most aural cholesteatomas, we attempted to characterize this cell population in more detail using monocyte/macrophage-specific monoclonal antibodies. KiM1+ (specific for CD 11c antigen, the 150kDa α-chain of a leukocyte integrin), and KiM6+ phagocytes were present in two- or fourfold higher numbers in the stroma of the six excised cholesteatomas than in the control tissues. Since the stroma of the cholesteatoma is devoid of microvessles, the typical perivascular localization of dermal macrophages was not seen in the cholesteatomas studied. The density of the macrophages in the normal ear skin was much higher in the upper dermis than in the lower dermis. In the cholesteatomatous specimens, the phagocytes were evenly scattered within the connective tissue and the cellular infiltrate. In contrast to diseased skin, no Mac 387+ macrophages were detected in the cholesteatomas. A great number of phagocytic cells closely resembling dermal macrophages was found in the stroma of the cholesteatomas and probably contributes to an active autoimmune process. [ABSTRACT FROM AUTHOR]

OBJECTIVES Cholesteatomas are benign well-circumscribed tumours formed by the progressive desquamation of a keratinizing stratified squamous epithelium inside a capsule. Their histopathologic aspect is the one of an epidermoid cyst, suggestively named "pearly tumour". It is a very rare tumour with many controversies surrounding it. Although it usually develops within the skull diploe, sometimes it can erode the inner cortical bone and cause mass effect, seizures or venous sinus obstruction. A patient with this kind of lesion is also at risk of developing serious complications such as brain abscesses or aseptic meningitis. Most of these tumours are found in the middle ear and/or mastoid process, while some of them may extend to the skull base from the mastoid. Cholesteatomas with other locations are very rare. MATERIALS AND METHODS We present the very rare case of a giant cholesteatoma located in the left temporal, frontal and parietal bone. RESULTS A 66-years old male was admitted to our clinic for a soft consistency tumour, located in the left parietal bone. The patient's medical history only mentioned hypertension and diabetes. The neurological examination was normal. We performed a gadolinium-enhanced MRI which indicated a massive frontotemporo- parietal extranevraxial tumor arising from the calvaria. The lesion was gadolinophilic, with cystic and tissue components, compressive on the left hemisphere, causing a 17 mm median line shift. The patient was operated and complete resection of the tumor was achieved by a fronto-temporo-parietal craniotomy. Once the craniotomy was performed, a mixed consistency epidural tumor measuring 13/13 cm was revealed, located in the concavity of the bone flap. The dura mater was not infiltrated. The histopathological examination indicated a cholesteatoma. There were no postoperative complications. Extensive imagistic examinations revealed no other cholesteatomas. CONCLUSIONS Cholesteatomas are rare, benign brain tumours. Even though cholesteatomas more frequently occur in the middle ear and skull base, sometimes locations can be surprising. Complete resection is the treatment of choice and it assures cure of the disease. [ABSTRACT FROM AUTHOR]