Kenneth Kee

Cholesteatoma, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions (eBook, ePUB)

• Format: ePub

Produktbeschreibung

This book describes Cholesteatoma, Diagnosis and Treatment and Related Diseases
Cholesteatoma is a form of skin cyst that is located in the middle ear and mastoid bone in the skull.
This lesion is incorrectly named, as it is not exactly a tumor nor is it made of cholesterol but rather it is a three-dimensional collection of epidermal and connective tissues within the middle ear.
Its importance lies in the fact that it grows independently and can be locally invasive and destructive, mainly affecting the bones of the middle ear.
Bone erosion happens mainly by pressure but release of osteolytic enzymes has been identified at the peripheral margins of the lesion.
Osteolytic activity seems to be enhanced by the presence of infection.
The (normally) unilateral lesion can give rise to a spectrum of disorders, ranging from painless otorrhoea (discharge from the ear) through to serious central nervous system complications.
Classification
Congenital cholesteatoma
This happens when squamous epithelium becomes trapped within the temporal bone during embryogenesis.
It enlarges, resulting in conductive hearing loss either through blockage of the Eustachian tube or by enclosing the ossicular chain.
Primary acquired cholesteatoma
It is thought that chronic negative middle-ear pressure because of an abnormal function of the Eustachian tube causes the tympanic membrane to be 'sucked back' and retract.
As this process persists, there is erosion of the lateral wall of the epitympanum , producing a slowly enlarging defect.
A pocket covered by squamous, non-keratinizing epithelium is then formed.
The erosion often persists, as the ball of epithelium grows, to enclose the ossicles and may spread into the mastoid bone, lateral semicircular canal, middle and posterior cranial fossa.
Secondary acquired cholesteatoma
This happens as a result of injury to the tympanic membrane, such as perforation due to acute otitis media (AOM) or damage, or because of surgical manipulation of the drum.
Squamous epithelium may be unintentionally implanted by the injury so activating the process of cellular growth leading to cholesteatoma formation.
Symptoms:
1.Dizziness
2.Drainage from the ear, which can be chronic
3.Hearing loss in one ear
Small lesions are linked with a progressive conductive hearing loss but, as the lesion grows and erodes into adjacent structures, there may be other features such as vertigo, headache and facial nerve palsy.
Diagnosis:
An ear exam may show a pus pocket or perforation in the eardrum, often with drainage.
A deposit of old skin cells may be visualized with an otoscope
1.Hearing to detect loss
2.CT imaging for option of surgery
Treatment
Cholesteatomas very often persist to grow if they are not resected.
Surgery is most often successful.
Medical treatment is reserved for those patients who refuse surgery or for whom a general anesthesia would be too hazardous owing to co-morbidity.
In these patients, regular ear cleaning with treatment of infections (topical ± systemic antibiotics) is advised
Surgical treatment
The purpose of surgery is to remove the cholesteatoma.
Surgery involves a general anesthesia and an incision behind the ear and in the auditory meatus.
There are two methods utilized:
1.Open technique (tympanomastoidectomy): this is a longer and more involved operation that involves removal of a number of structures
This is the more successful of the two types of procedure in terms of cholesteatoma removal and hence a single procedure is normally sufficient.
2.Closed technique (tympanoplasty): this method is linked with a better end result with regards to cosmetic appearance
There is a higher risk of persistent or recurring cholesteatomas

TABLE OF CONTENT
Introduction
Chapter 1 Cholesteatoma
Chapter 2 Causes
Chapter 3 Symptoms
Chap...

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Produktdetails

• Verlag: Kenneth Kee
• Erscheinungstermin: 17. September 2018
• Englisch
• ISBN-13: 9780463325728
• Artikelnr.: 53984862

Autorenporträt

Dr. Kenneth Kee is a well-known medical doctor from Singapore who has been practicing medicine since 1972.
He graduated from the University of Singapore and furthered his studies with a Master of Science in Health Management in 1991, followed by a Ph.D. in Healthcare Administration in 1993.
Dr. Kee established Kee Clinic in 1974, located in the Holland Drive area of Singapore. The clinic has been a prominent feature of the community, offering general medical services for 5 decades.
Dr Kee also served his country Singapore as a national service police Inspector at night from 1975 to 1985 while working at his clinic during the day.
He had served as a police guard to the Woodland Petroleum Tanks at night during the Indonesian Confrontation period, took part in police rounds at night in the Beach Road area and taught First aid and emergency resuscitation to Police recruits.
He received the Singapore Police Bicentennial 2020 Medallion on 1st March 2024 as recognition for his work in the Singapore Police.
Even as he grew older, Dr. Kee continued to work actively in his clinic, although he eventually reduced his consultation hours.
Beyond his medical career, Dr. Kee is also an author.
He started writing about medical conditions in 2007, using blogs and other online platforms to share his knowledge with a broader audience.
Over time, he published various books, many of which provide simple and accessible guides to different health conditions.
His works include "A Family Doctor's Tale," "My Personal Singapore History," and numerous medical guides, available through platforms like Amazon.
His books often combine his personal experiences as a family doctor with insights into Singapore's healthcare system and history.
Dr. Kee has written extensively on health topics, contributing to both medical literature and general knowledge resources.

Dr. Kenneth Kee has written numerous books, primarily focused on health education and personal experiences as a family doctor. Some of his notable titles include:
"A Family Doctor's Tale"
This book is a blend of Dr. Kee's personal experiences and his reflections on being a family doctor in Singapore. It's a great choice if you're looking for a narrative that combines both medical knowledge and human stories.
"Specialized Medical Conditions"
Books like **"Congestive Heart Failure: Diagnosis and Treatment"** focus on specific conditions, offering in-dept...