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Eur Arch Otorhinolaryngol 2021 Jun 5;278(6):1805-1813. Epub 2020 Aug 5.

European Institute for ORL-HNS, GZA Hospitals Antwerp, Oosterveldlaan 24, 2610, Wilrijk, Belgium.

Objective: To evaluate early results on hygiene, safety and functional outcome in a population undergoing a canal wall up technique with bony obliteration of the mastoid and epitympanic space (CWU-BOT) for extensive cholesteatoma, performed by a single surgeon. This study compares different techniques of tympanic membrane reconstruction, viz. allografts and autografts. Read More

Insights Imaging 2019 Oct 3;10(1):92. Epub 2019 Oct 3.

Department of Radiodiagnosis, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi, 110002, India.

Chronically discharging ear is a common cause of morbidity in developing countries, and it is also associated with intratemporal and intracranial complications. The surgeon is often able to detect the disease. However, cholesteatoma in the "hidden areas" like anterior epitympanic recess and sinus tympani can be missed. Read More

Otolaryngol Head Neck Surg 2019 05 1;160(5):891-893. Epub 2019 Jan 1.

5 Division of Hematology, Oncology, Blood and Marrow Transplant, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.

Cholesteatomas (CHSTs) are congenital or acquired lesions of the temporal bone that are associated with significant morbidity. We hypothesized that an oncolytic herpes simplex virus (oHSV) could preferentially eradicate primary human CHST cells in vitro and that this virus will replicate selectively and efficiently in CHST cells when compared with control cells. In this work, primary human CHST cells were cultured from surgically collected tissue. Read More

Laryngoscope 2019 04 8;129(4):981-985. Epub 2018 Nov 8.

Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands.

Objectives/hypothesis: The objective of this study was to evaluate surgical outcome and residual and recurrence rates of canal wall up (CWU) surgery with obliteration of the mastoid and epitympanum.

Study Design: Retrospective cohort study in a tertiary referral center.

Methods: Patients with (sequelae of) acquired cholesteatoma treated with primary or revision CWU surgery with obliteration of the epitympanum and mastoid were identified retrospectively from 2010 to 2014. Read More

Otol Neurotol 2018 09;39(8):e679-e682

Department of Otolaryngology, Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of Sao Paulo, Bauru, Brazil.

Objective: To review an institutional experience with the surgical and clinical management of acquired middle ear cholesteatoma in patients with ectrodactyly, ectodermal dysplasia, cleft lip/palate (EEC) syndrome.

Study Design: Retrospective chart review.

Setting: Tertiary referral center. Read More

Head Neck Pathol 2018 Sep 1;12(3):419-429. Epub 2018 Aug 1.

Department of Oral & Maxillofacial Pathology, Naval Postgraduate Dental School, Naval Medical Professional Development Center, 8955 Wood Road, Bethesda, MD, 20889-5638, USA.

The European Academy of Otology and Neurotology in collaboration with the Japanese Otological Society (EAONO/JOS) recently produced a joint consensus document outlining the definitions, classification and staging of middle ear cholesteatoma. The goals were to provide terminologies in the description of cholesteatoma, classify cholesteatoma into distinct categories to facilitate the comparison of surgical outcomes and to provide a staging system that reflects the severity, difficulty of complete removal and restoration of normal function. Cholesteatoma is considered a benign, expanding and destructive epithelial lesion of the temporal bone that is the result of a multifactorial process. Read More

J Int Adv Otol 2018 Apr;14(1):148-150

Department of Pathology, Pusan National University School of Medicine, Busan, Republic of Korea.

An inverted papilloma is a benign neoplasm that occurs exclusively in the sinonasal cavity; an inverted papilloma involving the mastoid cavity is extremely rare. We present the case of a patient with an inverted papilloma of the mastoid cavity secondary to cholesteatoma surgery. No case that occurred after acquired cholesteatoma has been reported in literature. Read More

BMJ Case Rep 2018 May 12;2018. Epub 2018 May 12.

Skull Base Unit, Queen Elizabeth Hospital, Birmingham, UK.

Temporal bone osteoma is an unusual pathology which can occur by birth or can be acquired and mostly involves the tympanomastoid segment of the temporal bone. Osteomas arising from the otic capsule are extremely rare, and there has been only one other report of a lateral semicircular canal osteoma in the literature. We report a similar case of an acquired lateral canal osteoma which presented as a chronic postaural fistula in an ear previously operated for paediatric cholesteatoma. Read More

Int J Pediatr Otorhinolaryngol 2018 Mar 2;106:80-84. Epub 2018 Feb 2.

Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Otolaryngology-Head and Neck Surgery, Chicago, IL, United States; Northwestern University Feinberg School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Chicago, IL, United States. Electronic address:

Introduction: The high incidence of chronic otitis media with effusion and Eustachian tube dysfunction in children with Down syndrome (DS) may predispose them to cholesteatoma formation. Establishing the diagnosis, choosing the appropriate operative intervention, and post-operative care can be challenging.

Objective: To describe management strategies for cholesteatoma diagnosis, surgical treatment, and post-operative management in children with Down syndrome. Read More

Eur Arch Otorhinolaryngol 2018 Mar 11;275(3):691-698. Epub 2018 Jan 11.

Department of Otolaryngology, Kamio Memorial Hospital, Tokyo, Japan.

Objective: For successful canal wall up tympanoplasty (CWUT) for the treatment of cholesteatoma, the restoration of stable middle ear aeration is also important; however, little is known about the dynamics of such aeration or the optimal surgical procedure. In this study, alternative additional surgical procedure was selected based on the grade of middle ear aeration during the second-stage operation.

Subjects And Methods: Patients included in this study underwent staged CWUT surgeries with mastoid cortex plasty (MCP) for well-aerated ears (grade 3) and bony mastoid obliteration (BMO) for poorly aerated ears (grade 2-0). Read More

Eur J Radiol Open 2017 14;4:144-146. Epub 2017 Nov 14.

Department of Radiodiagnosis DRPGMC, Tanda, Kangra, H.P., India.

Objective: To determine the use of multi-detector computed tomography (MDCT) in the diagnostic interpretation of superior semicircular canal dehiscence (SSCD) or thinning and its association with ear pathologies and to find whether it is an acquired condition and its association with increase in age.

Materials And Methods: study was performed in a tertiary care institute present in a village, following approval of the institutional ethical committee. Retrospective review of temporal bone CT examinations performed between September 2016 and March 2017 was done. Read More

Eur Arch Otorhinolaryngol 2017 Nov 21;274(11):3959-3964. Epub 2017 Aug 21.

Department of Radiology, Ondokuz Mayis University Faculty of Medicine, 55139, Atakum, Samsun, Turkey.

Cholesteatoma is a benign epithelial lesion affecting the middle ear and/or mastoid process, causing otorrhea and hearing loss. Here, we retrospectively evaluated the temporal multidetector computed tomography and audiological findings of acquired cholesteatoma in children. Forty-three patients younger than 18 years old with middle ear acquired cholesteatoma were evaluated with regard to their clinical symptoms, temporal multidetector computed tomography findings, and audiometry results. Read More

Eur Arch Otorhinolaryngol 2017 12 14;274(12):4251-4252. Epub 2017 Jun 14.

Department of Oral Surgery, Medical University of Gdansk, Smoluchowskiego 17, 80-214, Gdansk, Poland.

J Clin Diagn Res 2017 Mar 1;11(3):ED08-ED10. Epub 2017 Mar 1.

Specialist, Department of ENT, Deen Dayal Upadhyay Hospital, Delhi, India.

Cholesteatoma is a well demarcated, non-neoplastic, temporal bone cystic lesion with extensive keratinisation. Keratoma and epidermoid cyst are other possibly more accurate names suggested to describe the same. It can be classified as congenital or acquired. Read More

Auris Nasus Larynx 2018 Feb 6;45(1):45-50. Epub 2017 Mar 6.

Department of Otorhinolaryngology, Mitsui Memorial Hospital, Japan. Electronic address:

Objective: The Objective of this study was to assess the practicality of the cholesteatoma staging system proposed by the Japan Otological Society (JOS) for acquired middle ear cholesteatoma (the 2010 JOS staging system).

Methods: Between 2009 and 2010, 446 ears with retraction pocket cholesteatoma underwent primary surgery at 6 institutions in Japan. The extent of cholesteatoma was surgically confirmed, and classified into three stages. Read More

Clin Exp Otorhinolaryngol 2017 Sep 12;10(3):213-220. Epub 2017 Jan 12.

Department of Pathology, Fujita Health University School of Medicine, Toyoake, Japan.

Objectives: Cholesteatoma is a nonneoplastic destructive lesion of the temporal bone with debated pathogenesis and bone resorptive mechanism. Both molecular and cellular events chiefly master its activity. Continued research is necessary to clarify factors related to its aggressiveness. Read More

Auris Nasus Larynx 2017 Dec 29;44(6):766-770. Epub 2016 Dec 29.

Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.

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. Read More

Eur Arch Otorhinolaryngol 2017 May 16;274(5):2071-2078. Epub 2016 Dec 16.

Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.

Cholesteatoma is a destructive squamous epithelial lesion of the temporal bone which gradually expands and leads to serious complications by destruction of nearby bony structures. Erosion caused by bone resorption of the ossicular chain and bony labyrinth may result in hearing loss, vestibular dysfunction, facial paralysis, labyrinthine fistulae and intracranial complications. The exact underlying cellular and molecular mechanism of bone resorption in acquired cholesteatoma still remains unexplained. Read More

Acta Otolaryngol 2017 Feb 30;137(2):127-130. Epub 2016 Aug 30.

a Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.

Conclusions: Osteoclasts are unlikely to be involved in bone resorption in middle ear cholesteatoma.

Objective: The authors searched for osteoclasts in undecalcified bone sections in patients with middle ear cholesteatoma to determine whether and to what extent these cells are involved in this disease.

Methods: Twelve patients, eight men and four women, aged 30-87 years, who underwent tympanomastoidectomy were enrolled. Read More

Clin Exp Otorhinolaryngol 2016 Dec 21;9(4):298-308. Epub 2016 Jul 21.

Department of Otolaryngology, Second Hospital, Fujita Health University School of Medicine, Nagoya, Japan.

Cholesteatoma is a cystic non tumorous lesion of the temporal bone that has the ability to destroy nearby structures by its power to cause bone resorption and as a result, fatal complications prevail. We aimed to conduct a comprehensive review for pathogenesis of acquired cholesteatoma, bone resorption mechanisms, and offer a future vision of this serious disease. We have reviewed different theories for pathogenesis of acquired cholesteatoma including the most relevant and updated ones with special emphasis on the mechanisms of bone resorption through Medline/PubMed research using the keywords 'aetiopathogenesis, bone resorption, acquired cholesteatoma, temporal bone, and cytokines. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016 Feb;30(4):338-41

Cholesteatoma is a non-neoplastic, keratinizing lesion, characterized by the proliferation of epithelium with aberrant micro-architecture into the middle ear or mastoid cavity. The exact pathogenic molecular mechanisms behind the formation and propagation of cholesteatoma remain unclear. Without timely detection and intervention, cholesteatomas can become dangerous and result in numerous intracranial and extracranial complications. Read More

Laryngoscope 2017 03 16;127(3):698-701. Epub 2016 Jun 16.

Department of Otorhinolaryngology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.

Objectives/hypothesis: To highlight the phenomenon of cholesteatoma arising from the vascular strip following tympanoplasty and tympanomastoidectomy.

Study Design: Multi-institutional retrospective chart review.

Methods: Consecutive adult and pediatric patients evaluated between 2000 and 2015 with acquired cholesteatoma arising from the skin of a prior vascular strip were identified. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016 May;51(5):338-42

Department of Otorhinolaryngology, the First Hospital of China Medical University, Shenyang 110001, China.

Objective: To investigate the efficacy of operations of acquired middle ear cholesteatoma.

Methods: Retrospectively analyzed clinical data of 102 patients whom received tympanoplasty with CWU or CWD with mastoid obliteration in our hospital between January 2014 and December 2014. Patients were divided into different groups according to types of the cholesteatoma as well as the different surgical procedures. Read More

J Neurol Surg Rep 2016 Mar;77(1):e46-9

Organi di Senso Department, Sapienza University of Rome, Rome, Italy.

Petrous bone cholesteatomas (PBCs) are epidermoid cysts, which have developed in the petrous portion of the temporal bone and may be congenital or acquired. Cholesteatomas arising in this region have a tendency to invade bone and functional structures and the middle and posterior fossae reaching an extensive size. Traditionally, surgery of a giant PBC contemplates lateral transtemporal or middle fossa microscopic surgery; however, in recent years, endoscopic surgical techniques (primary or complementary endoscopic approach) are starting to receive a greater consensus for middle ear and mastoid surgeries. Read More

Eur Arch Otorhinolaryngol 2016 Sep 7;273(9):2533-40. Epub 2016 Jan 7.

Department of Otology and Skull Base Surgery, Gruppo Otologico, C/o Casa di Cura Piacenza Privata spa, Via Emmanueli, 42, Piacenza, Rome, 29121, Italy.

The objective of this study is to evaluate the outcomes of the modified Bondy's technique performed at our center and for limited epitympanic cholesteatomas and to debate the purported benefits of endoscopic surgery for the same indication. This is a retrospective study. 269 ears of 258 patients with a minimum of 5-year follow-up that were operated for limited epitympanic cholesteatoma using the modified Bondy's technique were included in the study. Read More

Auris Nasus Larynx 2016 Aug 9;43(4):387-94. Epub 2015 Oct 9.

Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC. Electronic address:

Objective: This article presents a points-based prognostic prediction model for pediatric acquired cholesteatoma, incorporating the multidimensional factors that contribute to surgical failure.

Methods: This study included 132 ears with acquired cholesteatoma from 128 children (≤18 years) identified between 1982 and 2012. Each case was scored for the extent of the cholesteatoma, history of grommet insertion, age of the patient, ossicular destruction, and otorrhea. Read More

Cell Tissue Bank 2016 Jun 5;17(2):199-204. Epub 2015 Sep 5.

Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.

Allograft tympano-ossicular systems (ATOS) have proven their use over many decades in tympanoplasty and reconstruction after resection of cholesteatoma. The transcranial bone plug technique has been used in the past 50 years to procure en bloc ATOS (tympanic membrane with malleus, incus and stapes attached). Recently, our group reported the feasibility of the endoscopic procurement technique. Read More

Eur Arch Otorhinolaryngol 2016 May 5;273(5):1155-60. Epub 2015 Jun 5.

Department of Otolaryngology Head and Neck Surgery, Niigata University Faculty of Medicine, Asahimachi-dori 1, Chuo-ku, Niigata, 951-8510, Japan.

This study examined the differences between congenital cholesteatoma (CC) and acquired cholesteatomas (AC) in children by comparing clinical features and treatment courses. This was a retrospective study which retrospectively evaluated 127 children with middle ear cholesteatomas using medical records from January 1999 to December 2012 in the Department of Otolaryngology, Niigata University Hospital. The study comprised 69 and 58 cases of CC and AC, respectively. Read More

Otol Neurotol 2015 Jun;36(5):776-81

*Department of Otolaryngology, Takanoko Hospital, Matsuyama, Ehime; and †Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.

Objectives: We investigated the factors that may possibly cause primary acquired cholesteatoma.

Setting: University-affiliated hospital.

Subjects And Methods: In 20 adult patients with unilateral cholesteatoma, the sizes of the osseous eustachian tubes (ETs) and the extent of peritubal and mastoid cell development in healthy and diseased ears were examined using high-resolution cone-beam computed tomography. Read More

Int J Pediatr Otorhinolaryngol 2015 Mar 7;79(3):316-22. Epub 2015 Jan 7.

Otolaryngology Department, University Hospital of Modena, Via del Pozzo 71, 41100 Modena, Italy.

Objectives: The aim of the present study is to describe our experience in the management of tympanic cavity cholesteatoma in pediatric patients, treated with endoscopic exclusive transcanal approach.

Methods: A chart review of clinical data and videos from the operations of 54 pediatric patients, undergoing surgery between January 2007 and December 2013, was made. Patients presenting with cholesteatoma involving the tympanic cavity (mesotympanum, epitympanum, protympanum and/or hypotympanum), with no mastoid involvement, were included in the first group and underwent an exclusive transcanalar endoscopic approach (TEA). Read More