Pediatric middle ear cholesteatoma: the comparative study of congenital cholesteatoma and acquired cholesteatoma

Morita, Yuka; Yamamoto, Yoshiharu; Oshima, Shinsuke; Takahashi, Kuniyuki; Takahashi, Sugata

doi:10.1007/s00405-015-3679-5

Cited by 19 publications

(14 citation statements)

References 17 publications

(19 reference statements)

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“…This result supports other similar studies. [3,15] In contrast to the work of Morita et al, [3] our study showed that intraoperative stapes superstructure deformity was greater in AC patients than in CC patients. Similarly, while stapes superstructure deformity was >40% in the study of McGuire et al, [7] in our study this rating was almost half in CC and even more in AC.…”

Section: Discussioncontrasting

confidence: 97%

“…Our study examined many characteristics of AC and CC such as diagnosis, treatment period and postoperative findings. Demographically, findings similar to those from the study of Morita et al [3] were obtained. Both AC and CC group had more male patients.…”

Section: Discussionsupporting

confidence: 86%

“…Moreover, while CC is generally limited, AC is extensively spread. The treatment for both CC and AC is surgery, [3] and different surgical approaches are needed because of differences between CC and AC.…”

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confidence: 99%

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Comparison of congenital and acquired cholesteatomas in pediatric patients

Demir¹

2018

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Objectives: This study aims to present clinical data and surgical results of patients with congenital cholesteatoma (CC) and acquired cholesteatoma (AC). Patients and Methods: Pediatric cholesteatoma patients who underwent tympanomastoid surgery between January 2008 and June 2015 were evaluated retrospectively. Demographic data, clinical symptoms, surgical and post-surgical findings were recorded. Mastoid development was evaluated with preoperative temporal bone computed tomography. Areas with cholesteatoma were mapped intraoperatively and cholesteatoma was staged. Intraoperative stapes superstructure deformation was assessed. Postoperative hearing results were compared according to air bone gap (ABG) values. Statistical analysis was made by Mann-Whitney U and Kruskal Wallis test. Results: We analyzed 60 patients (9 CC and 51 AC) under 16 years of age and followed at least six months. In the CC and AC groups, mean age was 6.1 and 10.4 years, and mean follow-up was 28 and 32 months, respectively. While CC group patients were generally asymptomatic, AC group patients were diagnosed with complaints of otorrhea, otalgia and hearing loss. Mastoid development was better in CC group patients (p<0.001). Intraoperatively, the AC mostly covered two or more regions while CC was mostly in one region. There was more deformity of stapes superstructure in AC group patients (p=0.019). Recurrence rates were similar for CC and AC groups and for different types of surgeries (p=0.128). Functional postoperative hearing (ABG ≤10dB) was 44.4% in the CC group and 25.4% in the AC group. Conclusion: The AC is more common than the CC, mastoid development is worse and ossicles are affected more. There are no significant differences in recurrence rates of applied surgeries. However, postoperative hearing results are better in patients who external ear canal preservation, which has an advantage of not causing more mastoidectomy cavity problems. With the main condition of completely removing pathology, these techniques can easily be preferred in cholesteatoma surgery.

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionsupporting

confidence: 86%

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Comparison of congenital and acquired cholesteatomas in pediatric patients

Demir¹

2018

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“…Even though osteoneogenesis is one of the symptoms of cholesteatoma, squamous epithelium may be rendered destructive in an environment of chronic infection, thereby also triggering osteolytic effects. In northern Europe there are approximately 9.2 new cases in 100,000 people per year 1 whereas the risk of a cholesteatoma is higher for male patients 2 . 16.9% of all patients show bilateral cholesteatomas 3 .…”

Section: Introductionmentioning

confidence: 99%

Stem cells in middle ear cholesteatoma contribute to its pathogenesis

Nagel

Wöllner

Schürmann

et al. 2018

Sci Rep

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Cholesteatoma is a potentially life-threatening middle ear lesion due to the formation of an inflamed ectopic mass of keratinizing squamous epithelium. Surgical removal remains the only treatment option, emphasizing the need to gain a better understanding of this severe disease. We show for the first time that stem cells residing in cholesteatoma tissue contribute to disease progression. Cells expressing the “stemness” markers Nestin and S100B were detected in middle ear cholesteatoma and auditory canal skin. Isolated Nestin + /S100B + -cells showed the capability for self-renewal, neurosphere formation and differentiation into mesodermal and ectodermal cell types. Compared to auditory canal skin stem cells middle ear cholesteatoma-derived stem cells displayed an enhanced susceptibility to inflammatory stimuli, and this suggested a possible contribution to the inflammatory environment in cholesteatoma tissue. Cholesteatoma derived stem cells were able to differentiate into keratinocyte-like cells using factors mimicking the microenvironment of cholesteatoma. Our findings demonstrate a new perspective on the pathogenesis of cholesteatoma and may lead to new treatment strategies for this severe middle ear lesion.

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“…At the same time, the Japan Otological Society (JOS) had been working independently on the "Classification and Staging of Cholesteatoma. " Its recommendations were formulated by the JOS steering board alone and are summarized in Appendix 2 [2][3][4][5][6][7][8][9][10][11][12][13][14][15] .…”

Section: Background On the Collaboration Between Eaono And Jos On Thementioning

confidence: 99%

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

Yung

Tono²,

Olszewska³

et al. 2017

Int Adv Otol

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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...

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Pediatric middle ear cholesteatoma: the comparative study of congenital cholesteatoma and acquired cholesteatoma

Cited by 19 publications

References 17 publications

Comparison of congenital and acquired cholesteatomas in pediatric patients

Comparison of congenital and acquired cholesteatomas in pediatric patients

Stem cells in middle ear cholesteatoma contribute to its pathogenesis

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

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