Etiopathogenetic aspects of recurrent cholesteatoma development

Arsović, Nenad; Djerić, D; Petrović, Z; Djordjević, Vladimir; Krejović-Trivić, Sanja; Djukić, Vojko

doi:10.1016/s0531-5131(03)00789-1

Cited by 6 publications

(11 citation statements)

References 7 publications

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“…Cholesteatoma concerning the shape and form of the lesion has been termed as a growth of abnormal keratinizing squamous epithelium with a collection of keratin debris [4,5] , cystic lesion [5] , three-dimensional structure [6] , cystic mass with a surrounding inflammatory reaction [7,8] , middle ear tumor [4] , form of chronic otitis media [3,9,10] , and "epidermoid cyst" [11] . It was called "skin in the wrong place" [12] .…”

Section: Definitionsmentioning

confidence: 99%

“…Many clinical, biochemical, and imaging abnormalities are typical for chronic otitis media, cholesteatoma. Chronic otitis media usually coexist in most individuals, especially in those with acquired one [10] . Therefore, with cholesteatoma is present concurrent with chronic otitis media and manifests itself with purulent otorrhea, tympanic membrane perforation, and/or hearing loss.…”

Section: Definitionsmentioning

confidence: 99%

“…Differences between residual and recurrent cholesteatoma have also been noted and discussed in the literature. Residual cholesteatoma is considered as the incomplete local resection of pathological squamous epithelium at the time of surgery [10,29] . However, "recurrence" is defined as the development of cholesteatoma after complete sur-gical removal and when a newly formed lesion arises from the retraction pocket [10] .…”

Section: Definitionsmentioning

confidence: 99%

“…Residual cholesteatoma is considered as the incomplete local resection of pathological squamous epithelium at the time of surgery [10,29] . However, "recurrence" is defined as the development of cholesteatoma after complete sur-gical removal and when a newly formed lesion arises from the retraction pocket [10] . The "tendency to recurrence" is also a designation often mentioned during cholesteatoma description [29] .…”

Section: Definitionsmentioning

confidence: 99%

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Cholesteatoma Definition and Classification: A Literature Review

Rutkowska

Özgirgin²,

Olszewska³

2017

Int Adv Otol

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Review INTRODUCTIONThe management of cholesteatoma continues to be a challenge for otolaryngologists around the world. Even in countries with advanced healthcare facilities, undertaking routine physical examinations, with good access to specialists, and where efforts are taken for the prevention, early detection, and treatment of cholesteatoma, there is a considerable prevalence of cholesteatoma and its complications in children and adults.Diagnosis of cholesteatoma is performed by otolaryngologists using different methods, including obtaining the history that is characteristic for cholesteatoma suspicion, searching for or evidence of cholesteatoma during the physical examination using otoscopy and/or otomicroscopy, and interpretation of imaging (computed tomography and/or magnetic resonance) [1].Despite the fact that cholesteatoma is diagnosed throughout the world, there are differences in the definition, classification, and management of cholesteatoma. These differences make it difficult to compare the reports in the literature, and limit the ability to derive further conclusions from individual or regional outcomes. Therefore, it is essential to create a common scientific language, with the definitions of an issue as a principle. Furthermore, utilizing a comparable classification system will allow investigators to share their experience across the world, leading to better assessment and management of cholesteatoma.To achieve this, a recent initiative aimed to explore opinions among the members of European Academy of Otology & Neuro-otology (EAONO) regarding the definition and classification of cholesteatoma. Although consensus was achieved on the cholesteatoma definitions, it could not be achieved on its classification [2] . The process of development of the questionnaires, the responses obtained from the EAONO members through three cycles of questionnaires, and the final set of statements were reported in detail. Here we report the literature review that led to the development of the questionnaire on the definitions and classification to provide a basis for the outcome. In addition, we present various classifications of cholesteatoma in the literature and emphasize the strengths and weaknesses of each of these classifications to stimulate an effort to develop a consensus on the classification as well. METHODSEAONO steering group decided to undertake the task of developing guidelines in the field of otology and neurotology. Guidelines regarding the assessment and management of cholesteatoma were established as a priority. Among the committees established, the task of developing the guidelines for the definition and classification of cholesteatoma was assigned to Ewa Olszewska in June Cholesteatoma Definition and Classification: A Literature ReviewCholesteatoma is a serious otolaryngologic condition that to date remains an important problem and poses a challenge to otolaryngologists around the world. To improve the approach pertaining to the diagnosis and management of middle ear cholesteatoma, clear, clinical...

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Section: Definitionsmentioning

confidence: 99%

Section: Definitionsmentioning

confidence: 99%

Section: Definitionsmentioning

confidence: 99%

Section: Definitionsmentioning

confidence: 99%

See 2 more Smart Citations

Cholesteatoma Definition and Classification: A Literature Review

Rutkowska

Özgirgin²,

Olszewska³

2017

Int Adv Otol

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“…On the other hand, they almost always destroy the lateral attic wall, thus increasing the risk of development of retraction pocket and recurrent cholesteatoma. Cholesteatomas localized in the retro tympanum (sinus cholesteatoma), especially if they were located in facial recess and tympanic sinus, are inclined to develop into recurrent cholesteatomas [4].…”

Section: Introductionmentioning

confidence: 99%

MRI as an Alternative to Second Look Mastoid Surgery

Gouda

Nasr

Elbary

et al. 2018

Indian J Otolaryngol Head Neck Surg

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The main goal of surgery of cholesteatoma is eradication of the disease and revision surgery is indicated when a dry and safe ear has not been achieved. Residual cholesteatoma usually occurs at the sites that are difficult to reach with an operating microscope, such as posterior tympanum and anterior epitympanic recess. Computed tomography can be performed to delineate the extent of disease. High-resolution computed tomography scanning is important for planning for surgery and is indicated for all revision mastoid operations. Magnetic resonance imaging is superior to computed tomography in tissue characterization for diagnosis of recurrent cholesteatoma. To evaluate the cases of recurrent cholesteatoma comparing the intraoperative surgical findings with the preoperative MRI radiological findings and if the preoperative MRI can replace the second look surgery for cholesteatoma. This study was applied on 60 patients that have a recurrent cholesteatoma after previous mastoid surgery. A preoperative radiological evaluation was done by Magnetic resonance, surgical management was done by canal wall up or canal wall down mastoidectomy to exclude residual disease. Then, radiological, and surgical findings correlation was done. Diffusion-weighted MRI successfully detected 42 cases out of the 45 cases of surgically proved cholesteatoma, it has accuracy 95%, sensitivity 93.33%, specificity 100%, PPV 100% and NPV 83.33%. MRI is better than CT in tissue characterization for diagnosis of recurrent cholesteatoma, and can replace the unnecessary second look surgery of cholesteatoma.

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Prognostic role of EAONO/JOS, STAMCO, and ChOLE Staging for Exclusive Endoscopic and Endoscopic‐Microscopic Tympanoplasty

Fermi

Bassano

Villari

et al. 2023

Otolaryngol.--head neck surg.

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Objective The aim of the study is to evaluate cholesteatoma's surgical outcomes in patients treated with endoscopic ear surgery (EES) or a combined endoscopic‐microscopic approach (cEMA) according to STAM, STAMCO, ChOLE, and EAONO/JOS system (EJS) classifications and staging. Study Design Retrospective study. Setting Monocentric study in a tertiary referral center. Methods One‐hundred sixty‐eight patients who underwent EES or cEMA for cholesteatoma between 2010 and 2018 were classified according to the abovementioned classification and staging. Data on cholesteatoma's recurrence and residual rates were collected. Inferential statistical analysis was performed to evaluate surgical outcomes and the prognostic value of classifications and staging. Results The recurrence rate was significantly lower in cholesteatomas classified in EJS stage 1 (2.6%) and STAM stage 1 (0%). A comparison of the different stages of the disease showed a significantly lower recurrence only for stage 1 versus the superior stages of both classifications. Involvement of mastoid bone was associated with a higher risk of recurrence (odds ratio [OR]: 4.12; p = .031). Attical involvement was associated with a higher risk of residual cholesteatoma (OR: 1.165; p = .046). Conclusion EES or cEMA represents an effective treatment for middle ear cholesteatoma. The STAM classification and the EJS have shown a prognostic value, with STAM 1 and EAONO‐JOS 1 stages associated with a better prognosis. Mastoid involvement represents a risk factor for recurrence. Attic localization is associated with residual disease. Localization at difficult access sites did not implicate a higher risk for recurrence or residual. ChOLE classification, Ossicular chain status, and complication status did not provide prognostic information regarding recurrence or residual cholesteatoma.

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Etiopathogenetic aspects of recurrent cholesteatoma development

Cited by 6 publications

References 7 publications

Cholesteatoma Definition and Classification: A Literature Review

Cholesteatoma Definition and Classification: A Literature Review

MRI as an Alternative to Second Look Mastoid Surgery

Prognostic role of EAONO/JOS, STAMCO, and ChOLE Staging for Exclusive Endoscopic and Endoscopic‐Microscopic Tympanoplasty

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