Kolesteatom

master's thesis

• Title (english): Cholesteatoma
• Author: Franjo Kodrić
• Mentor: Krsto Dawidowsky (mentor)
• Committee member: Srećko Branica (predsjednik povjerenstva)
• Committee member: Mihael Ries (član povjerenstva)
• Committee member: Krsto Dawidowsky (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Kolesteatom je benigna nakupina keratinizirajućeg skvamoznog epitela u srednjem uhu u obliku ciste. Patofiziološki se dijeli na urođeni (kongenitalni) i stečeni. Kongenitalni kolesteatom je specifičan za dječju dob, a pojavljuje se kao bjelkasta cistična masa koja nastaje tijekom embriogeneze iza urednog bubnjića bez povijesti upale srednjeg uha ili medicinske intervencije. Stečeni kolesteatom nastaje nakon rođenja prodorom keratinizirajućeg epitela lateralnog dijela bubnjića kroz retrakcijski džep ili perforaciju.
Simptomi kolesteatoma su: provodni gubitak sluha, otalgija, otoreja (iscjedak iz uha), glavobolja, vrtoglavica i povraćanje. Obično raste asimptomatski godinama prije početka simptoma što otežava ranu detekciju bolesti. Ako se ne liječi, može jako narasti i izazvati brojne intrakranijske i ekstrakranijske komplikacije.
Dijagnoza kolesteatoma postavlja se na osnovi kliničkog pregleda ili samo otoskopijom. Pri otoskopskom pregledu bubnjića treba staviti poseban naglasak na pregled atika i posterosuperiorni kvadrant. Radiološke pretrage uključuju kompjuteriziranu tomografiju (CT) kao primarnu metodu i magnetsku rezonancu (MR). Za detekciju oštećenja sluha, koje je najčešće provodnog tipa, koristimo audiološke pretrage: akumetriju, timpanometriju i audiometriju.
Kolesteatom se liječi operacijom koja ima za cilj potpuno odstranjenje tkiva kolesteatoma i restauraciju funkcije srednjeg uha. Praćenje bolesnika nakon operacije je važno za određivanje tijeka bolesti i otkrivanje recidiva.

Abstract (english)

Cholesteatoma is a benign collection of keratinizing squamous epithelium in the middle ear in form of a cyst. Cholesteatoma is pathophysiologically divided into congenital and acquired. Congenital cholesteatoma is specific to childhood and appears as a whitish cystic mass formed during embryogenesis behind intact eardrum without history of middle ear inflammation or medical intervention. Acquired cholesteatoma forms after birth and originates from the entrance of keratinizing epithelium from retraction pocket or damaged tympanic membrane.
Symptoms of cholesteatoma are: conductive hearing loss, otalgia, otorrhea, headache, dizziness and vomiting. Cholesteatoma usually grows asymptomatically for years before onset of symptoms, which makes early detection difficult. If left untreated, it can become dangerously large and cause number of intracranial and extracranial complications.
Diagnosis of cholesteatoma is based on clinical examination or solely on otoscopic exam of tympanic membrane with emphasis on attic and posterosuperior quadrant. Radiological examination includes Computed tomography, as the primary imaging technique, and Magnetic resonance imaging. Tuning fork tests and audiometric testing like tympanometry and audiometry are used to detect hearing deficiency which is most often conductive.
The treatment of cholesteatoma is surgical with aim of complete removal of cholesteatomatous tissue and restoration of middle ear functions. The follow-up is imperative to determine the course of the disease and detect recidivism.

• Keywords: Kolesteatom; kongenitalni kolesteatom; stečeni kolesteatom
• Keywords (english): Cholesteatoma; congenital cholesteatoma; acquired cholesteatoma
• Language: croatian
• URN:NBN: urn:nbn:hr:105:746295
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-13 09:07:27