Innovative Approaches to Managing Cholesteatoma
Innovative Approaches to Managing Cholesteatoma Questions:
1. **Question:** A 45-year-old patient presents with a history of chronic otitis media and a recent diagnosis of temporal lobe abscess secondary to cholesteatoma. What is the first-line surgical approach for managing this condition?
A) Transmastoid approach
B) Endolymphatic sac surgery
C) Stapedectomy
D) Cochlear implantation
E) Tympanoplasty
**Answer:** A) Transmastoid approach
**Explanation:** The transmastoid approach is commonly used for surgical management of cholesteatoma, especially when there is intracranial involvement, such as a temporal lobe abscess.
2. **Question:** In the management of cholesteatoma-associated temporal lobe abscess, which imaging modality is most crucial for preoperative planning?
A) Plain X-rays
B) MRI
C) PET scan
D) CT scan
E) Ultrasound
**Answer:** D) CT scan
**Explanation:** A CT scan is essential for assessing the extent of cholesteatoma and its relationship to surrounding structures, crucial for surgical planning.
3. **Question:** A patient with cholesteatoma and temporal lobe abscess develops facial nerve palsy postoperatively. What is the most likely cause?
A) Anesthetic complication
B) Infection spread to the facial nerve
C) Iatrogenic injury during surgery
D) Postoperative hematoma
E) Reaction to antibiotics
**Answer:** C) Iatrogenic injury during surgery
**Explanation:** Iatrogenic injury to the facial nerve is a risk during surgery for cholesteatoma, particularly when the disease process involves the facial nerve canal.
4. **Question:** Which of the following is a potential complication of untreated cholesteatoma leading to temporal lobe abscess?
A) Sensorineural hearing loss
B) Meniere’s disease
C) Vestibular schwannoma
D) Meningitis
E) Tinnitus
**Answer:** D) Meningitis
**Explanation:** Untreated cholesteatoma, especially when complicated by a temporal lobe abscess, can lead to meningitis due to the spread of infection.
5. **Question:** Following successful surgical management of cholesteatoma with associated temporal lobe abscess, what is the most critical aspect of postoperative care?
A) Immediate cochlear implantation
B) High-dose corticosteroid therapy
C) Regular audiometric evaluations
D) Long-term antibiotic therapy
E) Vestibular rehabilitation exercises
**Answer:** D) Long-term antibiotic therapy
**Explanation:** Long-term antibiotic therapy is crucial to manage any residual infection and prevent recurrence, especially in cases where intracranial extension was noted.