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The Tensor Tympani Tendon: A Hypothetical Site of Origin of Congenital Cholesteatoma

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Abstract

Multiple theories have been discussed about the etiopathogenesis of congenital middle ear cholesteatoma (CMEC) and its specific site of origin. The intraoperative identification of the precise location of the keratinous mass is important to guarantee its complete removal, in order to reduce the risk of recurrence. This study proposes the tensor tympani tendon (TTT) as a possible site of origin of CMEC. All CMECs treated between 2013 and 2019 were reviewed. Only Potsic stage I lesions were included. Preoperative radiologic images were compared to intraoperative findings. Three removed TTT were sent for histologic evaluation. Seven patients were included (M:F = 3:4). Preoperative CT images were classified as type A in 2 cases (28.6%) and type B in 5 cases (71.4%). At intraoperative evaluation all CMEC sacs were found pedunculated on the TTT. The histologic examinations confirmed the connection between the cholesteatomatous sac and the TTT. According to the correlation of imaging, intraoperative findings and histology, we proposed that the TTT could be the primary site from which CMEC originates.

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References

  1. Choi HG, Park KH, Park SN, Jun BC, Lee DH, Park YS, et al. Clinical experience of 71 cases of congenital middle ear cholesteatoma. Acta Otolaryngol. 2010;130:62–7.

    Article  PubMed  Google Scholar 

  2. Levenson MJ, Michaels L, Parisier SC. Congenital cholesteatomas of the middle ear in children: origin and management. Otolaryngol Clin North Am. 1989;22:941–54.

    Article  CAS  PubMed  Google Scholar 

  3. Potsic WP, Samadi DS, Marsh RR, Wetmore RF. A staging system for congenital cholesteatoma. Arch Otolaryngol Head Neck Surg. 2002;128(9):1009–12.

    Article  PubMed  Google Scholar 

  4. Molteni G, Fabbris C, Molinari G, et al. Correlation between pre-operative CT findings and intra-operative features in pediatric cholesteatoma: a retrospective study on 26 patients. Eur Arch Otorhinolaryngol. 2019;276(9):2449–56.

    Article  PubMed  Google Scholar 

  5. Lee CH, Kim SY, Kim HM, Kim YJ, Kim JY, Kim MK. Cochleariform Process Abutment on TBCT in Early Congenital Cholesteatoma. Otol Neurotol. 2017;38(1):79–85.

    Article  PubMed  Google Scholar 

  6. Michaels L. An epidermoid formation in the developing middle ear: possible source of cholesteatoma. J Otolaryngol. 1986;15:169–74.

    CAS  PubMed  Google Scholar 

  7. Cohen D. Locations of primary cholesteatoma. Am J Otol. 1987;8:61–5.

    CAS  PubMed  Google Scholar 

  8. Sadé J, Babiacki A, Pinkus G. The metaplastic and congenital origin of cholesteatoma. Acta Otolaryngol. 1983;96(1–2):119–29.

    Article  PubMed  Google Scholar 

  9. Ruedi L. Cholesteatoma formation in the middle ear in animal experiments. Acta Otolaryngol. 1959;50(3–4):233–42.

    Article  CAS  PubMed  Google Scholar 

  10. Aimi K. Role of the tympanic ring in the pathogenesis of congenital cholesteatoma. Laryngoscope. 1983;93:1140–6.

    Article  CAS  PubMed  Google Scholar 

  11. Tos M. A new pathogenesis of mesotympanic (congenital) cholesteatoma. Laryngoscope. 2000;110(11):1890–7.

    Article  CAS  PubMed  Google Scholar 

  12. Kashiwamura M, Fukuda S, Chida E, Matsumura M. Locations of congenital cholesteatoma in the middle ear in Japanese patients. Am J Otolaryngol. 2005;26(6):372–6.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, “B. Ramazzini” Hospital of Carpi, Carpi, Italy

    Francesco Maccarrone, Maria Paola Alberici, Sauro Tassi & Maurizio Negri

  2. Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy

    Francesco Maccarrone, Giulia Molinari, Domenico Villari & Matteo Alicandri-Ciufelli

  3. Department of Pathology, University Hospital of Modena, Modena, Italy

    Anna Maria Cesinaro

Authors
  1. Francesco Maccarrone
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  2. Giulia Molinari
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  3. Maria Paola Alberici
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  4. Anna Maria Cesinaro
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  5. Domenico Villari
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  6. Matteo Alicandri-Ciufelli
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  7. Sauro Tassi
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  8. Maurizio Negri
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Correspondence to Giulia Molinari.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this kind of retrospective investigation, our institutional review board does not perform a formal ethical assessment. This article does not contain any studies with animals performed by any of the authors.

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Maccarrone, F., Molinari, G., Alberici, M.P. et al. The Tensor Tympani Tendon: A Hypothetical Site of Origin of Congenital Cholesteatoma. Head and Neck Pathol 16, 224–228 (2022). https://doi.org/10.1007/s12105-021-01342-4

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  • DOI: https://doi.org/10.1007/s12105-021-01342-4

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