title: Attic cholesteatoma with closure of the entrance to pars flaccida retraction pocket.
abstract: We report three patients with pars flaccida-type cholesteatoma (attic cholesteatoma) with closure of the entrance to the cholesteatoma at the time of surgery. These patients were diagnosed with attic cholesteatoma requiring surgery on the basis of abnormal findings of the pars flaccida, audiometry, and temporal bone computed tomography during the clinical course. Intraoperatively, cholesteatoma matrix and granulation tissue were observed behind the intact pars flaccida epithelium, which suggested that the entrance had apparently closed and the continuity with the cholesteatoma matrix disappeared after resolution of inflammation at the pars flaccida. In such patients, a normal pars flaccida may cause cholesteatoma to be initially overlooked, or misdiagnosed as congenital cholesteatoma. The diagnosis should be carefully made on the basis of the clinical course and the results of various examinations.
authors.affiliation: Department of Otolaryngology, Saitama Citizens Medical Center, Saitama-shi, Nishi-ku, Shimane 299-1, Saitama, Japan; Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan. Electronic address: matsu_zawa_s@jichi.ac.jp.
authors.forename: Shingo
authors.initials: S
authors.lastname: Matsuzawa
authors.affiliation: Department of Otolaryngology, Tokyo-Kita Medical Center, Kita-ku, Akabanedai 4-17-56, Tokyo, Japan; Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Iino
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.
authors.forename: Daiki
authors.initials: D
authors.lastname: Yamamoto
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Hara
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shinnabe
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kanazawa
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yoshida
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D018424:Cholesteatoma, Middle Ear / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006097:Granulation Tissue / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D013701:Temporal Bone / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
keywords: Acquired cholesteatoma; Closure; Pars flaccida; Retraction pocket; Words attic cholesteatoma