EAONO/JOS Joint Consensus Statements on the Definitions, Classification and Staging of Middle Ear Cholesteatoma

Abstract

ReviewThe aims of the European Academy of Otology and Neurootology/Japan Otological Society (EAONO/JOS) Joint Consensus Statements on Definition, Classification and Staging are as follows:1. The definitions provide terminologies in the description of cholesteatoma. 2. The classification categorized cholesteatoma into distinct categories to facilitate the comparison of surgical outcomes across reports. 3. The staging system reflects the severity of the cholesteatoma, the difficulty to achieve complete removal, and the subsequent restoration of normal function.The authors wish to present the final consensus first, followed by an explanation of the methodology on how the EAONO/JOS consensus was reached by the steering group.The clinical classification of middle ear mucosa is summarized in Figure 1. 1 EAONO/JOS Joint Consensus Statements on the Definitions, Classification and Staging of Middle Ear CholesteatomaThe European Academy of Otology and Neurotology (EAONO) has previously published a consensus document on the definitions and classification of cholesteatoma. It was based on the Delphi consensus methodology involving the broad EAONO membership. At the same time, the Japanese Otological Society (JOS) had been working independently on the "Classification and Staging of Cholesteatoma." EAONO and JOS then decided to collaborate and produce a joint consensus document. The EAONO/JOS joint consensus on "Definitions, Classification and Staging of Middle Ear Cholesteatoma" was formally presented at the 10th International Conference on Cholesteatoma and Ear Surgery in Edinburgh, June 5-8, 2016. The international otology community who attended the consensus session was given the chance to debate and give their support or disapproval. The statements on the "Definitions of Cholesteatoma" received 89% approval. The "Classification of Cholesteatoma" received almost universal approval (98%). The "EAONO/JOS Staging System on Middle Ear Cholesteatoma" had a majority of approval (75%). Some international otologists wanted to see more prognostic factors being incorporated in the staging system. In response to this, the EAONO/JOS steering group plans to set up an "International Otology Outcome Working Group" to work on a minimum common otology data set that the international otology community can use to evaluate their surgical outcome. This will generate a large database and help identify relevant prognostic factors that can be incorporated into the staging system in future revisions. KEYWORDS:2 J Int Adv Otol 2017; 13(1): 1-8 Definitions and Statements on Cholesteatoma1. Cholesteatoma is a mass formed by the keratinizing squamous epithelium in the tympanic cavity and/or mastoid and subepithelial connective tissue and by the progressive accumulation of keratin debris with/without a surrounding inflammatory reaction.2. Cholesteatoma consists of matrix (keratinizing squamous epithelium), perimatrix (varying thickness of the subepithelial connective tissue), and keratin debris.3. The pathophysiology of cholesteatoma is not completel...

Introducing the “ChOLE” Classification and Its Comparison to the EAONO/JOS Consensus Classification for Cholesteatoma Staging

“…There have been previous attempts to classify cholesteatoma disease, but none has been widely adopted. Some have modified the TNM system used for tumors, and others have relied on anatomical barriers or classified prognostic factors (1)(2)(3)(4)(5).…”

Congenital Cholesteatoma of the Temporal Bone: Issues Associated With Its Etiology, Diagnostics and Treatment (A Literature Review)

“…Касаясь вопросов диагностики, стоит отметить, что для данной формы холестеатомы характерно бессимптомное течение. Таким образом, обследование пациентов зачастую происходит на этапе появления осложнений, таких как тугоухость, парез мимической мускулатуры, вестибулопатия, интра-и экстракраниальные осложнения [3,11,35,36].…”

“…Жалобы на головокружение, периодическую головную боль, тинитус также могут быть манифестацией врожденной холестеатомы височной кости. [3,35,36]. К современным методам диагностики холестеатомы височной кости относят отомикроско-пию, компьютерную томографию (КТ) височных костей, магнитно-резонансную томографию (МРТ) среднего уха в DWI режиме.…”

“…Холестеатома -опухолевидное образование, представляющее собой эпидермальную кисту, которая является результатом агрессивного роста ороговевающего плоскоклеточного эпителия [1][2][3].…”

Aktuelle Aspekte der Cholesteatomchirurgie – Teil 1: Grundlagen und Diagnostik

“…Das Cholesteatom ist eine Form der chronischen Otitis media. In Anlehnung an den europäischen Konsensus wird es als eine "Progressive Ansammlung von Keratin bildendem, verhornendem Plattenepithel in Paukenhöhle, Mastoid oder dem subepithelialen Bindegewebe mit oder ohne umgebende Entzündungsreaktion" definiert [1].…”