The peculiar clinical features of different types of acquired cholesteatoma of the middle ear

Abstract

We have undertaken the analysis of the specific clinical manifestations of acquired cholesteatoma of the middle ear in 437 chronic patients suffering from this pathology. 96.1% of them presented with primarily acquired cholesteatoma of the middle ear (including 53.3% having attic cholesteatoma, 22.8% with sinus cholesteatoma, and 19.9% of tensa retraction cholesteatoma). 3.9% of the patients exhibited a different mechanism of development of cholesteatoma. The secondary acquired mesotympanic cholesteatoma formed in association with the long-term chronic inflammation of the middle ear, concomitant perforation of the tympanic membrane and epithelial invasion from the edge of the tympanic membrane perforation and middle ear cavity. Typmanosclerosis of different degree and localization played an important role in the enhancement of the prevalence of this condition. All types of acquired cholesteatoma were found to extend beyond the point of origin of the disorder. The maximum destruction of the ossicular chain was documented in the patients presenting with sinus cholesteatoma. Those with secondary acquired cholesteatoma showed the worst functional capacity as a result of rigid fixation of the auditory ossicles. The overall cholesteatoma relapse rate (including both residual and recurrent cholesteatoma) was estimated to be 15.6%. It is concluded that the surgical strategy should be chosen on an individual basis for each concrete patient. The long-term observation of the treated patients with the application of the up-to-date radiological techniques is believed to be the indispensable prerequisite for the successful management of the complicated pathology under consideration.