Cholesteatoma

A non-neoplastic mass of keratin-producing squamous EPITHELIUM, frequently occurring in the MENINGES; bones of the skull, and most commonly in the MIDDLE EAR and MASTOID region. Cholesteatoma can be congenital or acquired. Cholesteatoma is not a tumor nor is it associated with high CHOLESTEROL.

Also Known As:

Networked: 2097 relevant articles (93 outcomes, 327 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Suppurative Otitis Media
2.	Otitis Media
3.	Granuloma
4.	Neoplasms (Cancer)
5.	Pathologic Constriction (Stenosis)

Experts

1.	Olszewska, Ewa: 14 articles (03/2016 - 05/2002)
2.	Liu, Wei: 13 articles (12/2022 - 08/2005)
3.	Chole, Richard A: 13 articles (01/2018 - 03/2002)
4.	James, Adrian L: 12 articles (01/2022 - 01/2010)
5.	Marchioni, Daniele: 10 articles (08/2021 - 08/2008)
6.	Migirov, Lela: 10 articles (06/2016 - 04/2005)
7.	Kojima, Hiromi: 9 articles (11/2022 - 09/2003)
8.	Kuczkowski, Jerzy: 9 articles (08/2022 - 01/2004)
9.	Presutti, Livio: 9 articles (01/2022 - 08/2008)
10.	Ren, Jihao: 9 articles (12/2021 - 01/2013)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Cholesteatoma:

1.	Anti-Bacterial Agents (Antibiotics)IBA 01/01/1989 - "In five cases of labyrinthine fistulae caused by extensive cholesteatoma, more than 30-dB improvement in bone conduction was observed in four postoperative cases and in one case after preoperative administration of antibiotics. " 01/01/2021 - "Extra- and intracranial complications of cholesteatoma are rare in the new era of antibiotics. " 06/26/2013 - "Neck disease secondary to cholesteatoma has become nearly extinct with better clinical imaging and sensible antibiotic usage. " 01/01/2012 - "High hydrostatic pressure conditions that are suitable to inactivate cholesteatoma cells fail to completely sterilize ossicles even if antibiotics are added. " 07/01/2007 - "The surgical treatment consisted in the cleaning of the sinus associated with an antibiotic treatment in one case and the cholesteatoma matrix removal in the other. "
2.	Ciprofloxacin (Cipro)FDA LinkGeneric 11/01/1992 - "The results of this study show that children with chronic suppurative otitis media without cholesteatoma can be effectively treated with oral ciprofloxacin. " 11/01/1992 - "Oral ciprofloxacin in the management of chronic suppurative otitis media without cholesteatoma in children: preliminary experience in 21 children." 10/01/1997 - "To evaluate the efficacy of ciprofloxacin compared with tobramycin and placebo ear drops in the treatment of chronic suppurative otitis media without cholesteatoma. " 08/01/1992 - "We admitted to the study only adult patients affected by chronic otitis media in the acute stage with perforation of the tympanic membrane, without cholesteatoma, whose bacteriological culture was positive for Pseudomonas susceptible in vitro to ciprofloxacin and gentamicin. " 08/01/2003 - "In topical administration, a difference was only observed in the cholesteatoma and chronic middle ear infection with bone reabsorption groups, in those patients that were administered the ciprofloxacin with fluocinolone. "
3.	Fluorouracil (Carac)FDA LinkGeneric 10/01/1985 - "The use of topical 5-fluorouracil in the management of hyperkeratosis, cholesteatoma in the middle ear and mastoid, and in the external canal has been almost 100% effective with very few side effects. " 10/01/1985 - "A retrospective study has suggested a very impressive efficacy of topical 5-fluorouracil in the management of cholesteatoma and, to a lesser degree, control of hyper-mucus-secreting cells at locations in the middle ear and mastoid. " 12/01/2005 - "5-FU topical cream appeared effective for the treatment of cholesteatomas." 01/01/1987 - "The use of applied 5-Fluorouracil is effective in the treatment of cholesteatoma. " 10/01/2008 - "The effect of 5-FU on cholesteatoma seems to be mediated, at least in part, through downregulation of KGF in stromal cells and reduction of the proliferative activity of epithelial cells."
4.	CholesterolIBA 01/01/1982 - "This study is an attempt to establish the topographic relationship, frequency, and source of cholesterol crystal deposits in cholesteatoma and related conditions." 08/01/2021 - "Tissue-resident macrophages (TRMØs) can act as innate-immune sentinels to protect body against microbe invaders and stimulating materials such as cholesterol crystals in cholesteatoma, as well as to preserve tissue integrity by cleaning unwanted cellular debris. " 08/01/2016 - "The content of cholesterol in the cholesteatoma matrix is significantly different from that in stratum corneum from skin, and we confirm that the main structure of the cholesteatoma resembles very thick stratum corneum." 08/01/2016 - "The cholesterol content in the cholesteatoma matrix is increased by over 30% (w/w dry weight) compared to the control. " 08/01/2016 - "Biochemical and Bioimaging Evidence of Cholesterol in Acquired Cholesteatoma."
5.	Mesna (Coenzyme M)FDA LinkGeneric 08/01/2021 - "All the studies showed overall improvement in recurrence and residual cholesteatoma disease after Mesna application during surgery. " 01/01/2023 - "A synthetic sulphur compound (MESNA) may have an interesting role in the overall improvement in recurrence and residual cholesteatoma disease. " 07/01/2018 - "This is the first study that showing changes associated with cholesteatoma in the structure of the bacterial biofilm after the application of MESNA. " 12/01/2014 - "This study showed that chemically assisted dissection by using mesna represents a valid support in reducing the frequency of residual disease in cholesteatoma surgery." 12/01/2014 - "In the study group, the cholesteatoma removal was performed with the support of chemically assisted dissection by using mesna. "
6.	Ceftazidime (Fortum)FDA LinkGeneric 07/01/1992 - "Our results demonstrate that a regiment combining daily aural toilet and twice daily parenteral ceftazidime is highly efficacious in resolving ear discharge in children with chronic suppurative otitis media without cholesteatoma and that such a regimen does not require hospitalization." 03/01/1993 - "Ceftazidime for therapy of children with chronic suppurative otitis media without cholesteatoma." 10/01/1994 - "Twice-daily canal aspiration and parenteral ceftazidime for Gram-negative organisms and/or oxacillin for Gram-positive bacteria for 3 days after dryness of the middle ear followed by prophylactic oral antimicrobials are effective for treatment of most chronic suppurative otitis media without cholesteatoma patients." 01/01/2000 - "In a prospective, open, randomized trial, ceftazidime was given to 15 children and aztreonam to another 15 children with chronic suppurative otitis media without cholesteatoma (CSOM). " 06/01/1990 - "To determine whether systemic administration of antibiotics may eliminate or reduce the need for tympanomastoid surgery in chronic suppurative otitis media without cholesteatoma, we undertook a randomized, prospective study comparing three regimens: (1) daily suction and débridement, with intravenous administration of mezlocillin until 3 days after the discharge stopped, (2) daily suction and débridement, with intravenous use of ceftazidime until 3 days after the discharge stopped, and (3) daily suction and débridement without antibiotics. "
7.	Tobramycin (Nebcin)FDA LinkGeneric 10/01/1997 - "To evaluate the efficacy of ciprofloxacin compared with tobramycin and placebo ear drops in the treatment of chronic suppurative otitis media without cholesteatoma. " 03/01/2002 - "To evaluate the efficacy of topical ciprofloxacin and tobramycin with and without topical dexamethasone in the treatment of chronic suppurative otitis media without cholesteatoma. "
8.	Proteins (Proteins, Gene)FDA Link 09/15/2023 - "The aim of the present study was to determine the biological activity of cholesteatoma through the analysis of the expression and localization of immunoproteasome subunits of low molecule weight protein (LMP) 2 and LMP7. " 06/01/2023 - "This study aimed to identify the potential mechanisms of the proliferation and growth of cholesteatoma by analysis of the differential expressions of proteins in cholesteatoma and retroauricular skin tissue collected from the same patients. " 01/01/2015 - "Our study shows that protein expression patterns are completely different in congenital cholesteatomas, acquired cholesteatomas, and skin. " 01/01/2015 - "In this study, key proteins that directly affect cholesteatoma pathogenesis are investigated with proteomics and immunohistochemistry. " 01/01/2014 - "The presented data on the differential protein composition in cholesteatoma corroborate previous studies, highlight novel protein functionalities involved in the pathogenesis, and identify new areas for targeted research that hold therapeutic potential for the disease. "
9.	Tumor Necrosis Factor-alpha (Tumor Necrosis Factor)IBA 02/01/2001 - "This study revealed significantly increased level of TNF-alpha in cholesteatoma tissues. " 01/01/2001 - "To study the expression of TNF-alpha in the cholesteatoma and elucidate the role of TNF-alpha in the destruction of bone. " 01/01/2001 - "[The study of TNF-alpha destructive action to the bone in human middle cholesteatoma]." 03/01/1999 - "An attempt was made in this study to show a correlation between TNF-alpha and cholesteatoma associated bone destruction by localizing TNF-alpha in cholesteatoma and measuring its serum level. " 03/01/1999 - "This study was undertaken to define the role of tumor necrosis factor-alpha (TNF-alpha) in bone destruction associated with cholesteatoma. "
10.	EnzymesIBA 12/01/2006 - "These findings imply that SLPI contributes to host protection against inflammatory cell and destructive enzymes in the chronic inflammatory state of cholesteatoma by affecting the innate immune system." 01/01/1990 - "In an attempt to further characterize this model, we compared experimentally induced cholesteatomas in the external auditory canal from gerbils with those of the human ear by means of a correlated histopathologic and enzyme histochemical study. " 01/01/2022 - "The presence of NOS enzymes in the middle ear mucosa indicates an ongoing NO production and the reduction of NOS in ears with cholesteatoma, and pooled samples from ears with COM, suggest a role for locally produced NO in middle ear disease." 03/01/2016 - "In cholesteatoma tissues, the expression of the investigated enzyme and its inhibitor was higher than in normal skin specimens, limited mostly to cholesteatoma perimatrix. " 06/01/2012 - "The mean concentration of activity of HEX 1142.39 pKat/ml, GAL 8.90 pKat/ml, and GLUC 14.06 pKat/ml was significantly higher compared with the concentration of enzyme activity in normal tissue: HEX 267.65 pKat/ml, GAL 3.44 pKat/ml, and GLUC 3.90 pKat/ml. In the serum of cholesteatoma patients, the mean concentration of enzyme activities were as follows: HEX 641.62 pKat/ml, GAL 4.55 pKat/ml, and GLUC 12.80 pKat/ml and were significantly higher compared with the concentration of HEX activity (215.75 pKat/ml), GAL (1.89 pKat/ml), and GLUC (5.51 pKat/ml) in the serum of the healthy control group. "

Therapies and Procedures

1.	Mastoidectomy 01/01/2016 - "Canal wall down mastoidectomy is one of the most effective treatments for cholesteatoma. " 12/01/2023 - "We report two cases where a canal wall down mastoidectomy is made due to the characteristics of the cholesteatoma, achieving good outcomes in relation to bone conductive hearing. " 08/01/2022 - "Though there is no statistically significant difference in recurrence of cholesteatoma and complications rate in CWU and CWD Tympano-mastoidectomy techniques, but CWUT is superior to CWDT in terms of better graft uptake (p = 0.0156), and better average audiological gain (8.56 ± 0.93 dB) with p value = 0.0315. " 12/01/2019 - "Our direct comparative data suggest that canal wall down mastoidectomy with obliteration is superior to a canal wall up technique in primary cholesteatoma surgery, providing a lower recidivism rate combined with a low post-operative ear discharge rate." 11/01/2012 - "The mainstay of treatment for cholesteatoma is surgery and the surgical treatment of choice is modified radical mastoidectomy. "
2.	Tympanoplasty 01/01/2004 - "The best treatment results in children cholesteatoma are obtained in early clinical stage and with open tympanoplasty procedure." 03/01/1995 - "In 12 operations, lateral graft tympanoplasty eradicated the cholesteatoma in one stage; 32 patients required a second-stage surgery to rule out recurrence, and the remaining 16 cases required three or more operations to eradicate disease and reconstruct the hearing mechanism. " 01/01/1983 - "The 3A-scopy was effective in postoperative observations of the cavity which had undergone intact canal wall tympanoplasty, especially in the diagnosis of recurrent or residual cholesteatoma and in the observation of the postoperative cavity in the cases with long-standing discharge." 08/01/2023 - "To investigate safety and efficacy of mastoid obliteration in canal-wall-down tympanoplasty performed for cholesteatoma using bioactive glass (BAG). " 01/01/2018 - "The CWU bony obliteration tympanoplasty in a consecutive series of pediatric extensive cholesteatoma shows a similar to slightly improved hearing outcome as compared with CWU surgery without BOT. "
3.	Endoscopes 08/01/2008 - "The endoscope allowed a better understanding of cholesteatoma and improved eradication of residual disease from hidden areas such as the anterior epitympanic recess, retrotympanum, and hypotympanum not yet controllable by the operating microscope." 01/01/2001 - "Combined use of an operating microscope and a middle ear endoscope seems to be helpful for selecting an appropriate surgical technique and for identifying more patients in whom cholesteatoma can be removed by a trans-canal approach alone. " 04/01/1994 - "It is concluded from this study that side-viewing endoscopes could be very useful in cholesteatoma surgery." 04/01/2022 - "Objectives  To utilize endoscopes to visualize and manipulate cholesteatoma residues after microscopic removal Methods  Cross-sectional study. " 01/01/2022 - "This study aimed to determine the effectiveness of using endoscopes in reducing recidivism secondary to residual cholesteatoma after canal wall-up tympanomastoidectomy. "
4.	Second-Look Surgery 03/01/2017 - "The oto-endoscopy led to a significant increase (p < .01) of the transcanalar approach and to a significant reduction (p < .05) of residual cholesteatoma at the second look surgery." 02/01/2011 - "Studies using DW-non-EPI and DWI-PROPELLER sequences show promising results related to improved diagnostic sensitivity and specificity for even small (<5 mm) cholesteatomas, thus allowing avoidance of second-look surgery in the future." 01/01/1999 - "Therefore second look surgery is the gold standard study to diagnosis a residual cholesteatoma. " 01/01/2009 - "TSE DW MRI holds great promise in screening for cholesteatoma as an alternative to exploratory second-look surgery." 01/01/2009 - "In 16 cases shown to be negative on DW MRI for cholesteatoma, all were confirmed to be disease-free on second-look surgery. "
5.	Therapeutics 01/01/2008 - "Many animal models were used, unsuccessfully, to study an alternative therapy to cholesteatoma. " 09/01/2023 - "While HRQoL plays a secondary role in establishment of the indication for surgical therapy in COM with cholesteatoma, it plays an important role in terms of relative surgical indications, e.g., a symptomatic open mastoid cavity after resection of the posterior canal wall. " 07/31/2023 - "They can be packaged into exosomes and transported to target cells that can be used in the future therapy of cholesteatoma. " 11/01/2022 - "Galectin-7-targeted aptamers could benefit molecular imaging-guided surgical treatment, which would enable clinicians to not only intraoperatively detect the locations of cholesteatoma matrix in the middle ear, but also assess the postoperative response of the expression profile to therapy. " 08/21/2022 - "So far, no medical treatment is available for cholesteatoma (C) and the only effective therapy is complete surgical removal, but recurrence is common even after surgical treatment. "