Cholesterol granuloma of the middle ear in post-irradiated nasopharyngeal carcinoma patients.
OBJECTIVE
To evaluate the surgical outcome of tympanoplasty with mastoidectomy for cholesterol granuloma of the middle ear in post-irradiated patients with nasopharyngeal carcinoma (NPC).


METHODS
Nine post-irradiated NPC patients diagnosed with cholesterol granuloma in a single-sided middle ear were included in this study. The time from radiotherapy termination to surgery ranged from 6 to 14 years (median 9 years). All patients underwent radical tympanoplasty with canal wall down or up mastoidectomy.


RESULTS
All the patients with NPC received radiotherapy of 68-75 Gy before surgery. Three ears underwent tympanoplasty with canal wall down mastoidectomy, and 6 ears underwent tympanoplasty with canal wall up mastoidectomy. All the patients were followed up for at least 2 years. Seven ears (77.8%) had an intact tympanic membrane and 2 ears developed re-perforation of the eardrum 3 months after surgery, but otorrhea decreased significantly. All these patients reported improved quality of life after surgery. Before the operation, the pure tone averages (0.25, 0.5, 1, 2 kHz) were 90.5 dB and the air-bone gaps (0.5, 1, 2 kHz) were 45.8 dB (vs. 62.3 and 25.5 dB, respectively, at 6 months after the operation).


CONCLUSIONS
Most post-irradiated NPC patients with cholesterol granuloma of the middle ear benefit from this surgery. Chronic otitis media caused by radiotherapy is not a contraindication to tympanoplasty.
Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Haidi
H
Yang
Yiqing
Y
Zheng
Suijun
S
Chen
Maojin
M
Liang
Zhigang
Z
Zhang
Yaodong
Y
Xu
Xiang
X
Liu
D000328:Adult; D000368:Aged; D018424:Cholesteatoma, Middle Ear / Q000378:metabolism / Q000473:pathology* / Q000601:surgery*; D002784:Cholesterol / Q000378:metabolism; D005260:Female; D006099:Granuloma / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D010033:Otitis Media / Q000209:etiology; D011788:Quality of Life; D011832:Radiation Injuries / Q000150:complications; D011878:Radiotherapy / Q000009:adverse effects; D016896:Treatment Outcome; D014433:Tympanoplasty
D002784:Cholesterol