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European Archives of Oto-Rhino-Laryngology
Erschienen in: European Archives of Oto-Rhino-Laryngology 4/2020

18.01.2020 | Otology

Middle ear congenital cholesteatoma: systematic review, meta-analysis and insights on its pathogenesis

verfasst von: Nelson Gilberto, Sara Custódio, Tiago Colaço, Ricardo Santos, Pedro Sousa, Pedro Escada

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 4/2020

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Abstract

Purpose

Congenital cholesteatoma (CC) presents as a white pearl-like lesion behind a normal tympanic membrane (TM), without a history of otorrhea, infection, perforation or previous otologic surgery. Several recent studies provided new data improving this pathology characterization. The aim of this paper is to expand the knowledge about CC and to provide new insights on its pathogenesis.

Methods

The study consisted of two main research parts: (1) systematic review and meta-analysis; (2) medical literature review englobing anatomy, histology, embryology and congenital pathology of the ear.

Results

The search strategy identified a total of 636 papers. Seventy retrospective studies were included. A total of 1497 cases were studied and the mean age was 6.58 years, with a male–female ratio of 3:1, 34% were asymptomatic, 26% had hearing loss and 2% had facial dysfunction/paralysis. The overall estimate for antero-superior quadrant involvement was 0.70 [95% confident interval (CI) 0.64–0.76], in the postero-superior quadrant was 0.60 (95% CI 0.52–0.69), in the antero-inferior quadrant was 0.32 (95% CI 0.23–0.41), in the postero-inferior quadrant was 0.38 (95% CI 0.29–0.47), in the attic was 0.53 (95% CI 0.43–0.63) and in the mastoid was 0.33 (95% CI 0.26–0.41). More advanced Potsic stages were present in older patients. The most likely inclusion place seems to be between the pars flaccida and the upper quadrants of the pars tensa.

Conclusions

During the last decades, a substantial improvement in CC diagnosis and management had been achieved. The presented mechanism seems to explain most of middle ear CC.
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Metadaten
Titel
Middle ear congenital cholesteatoma: systematic review, meta-analysis and insights on its pathogenesis
verfasst von
Nelson Gilberto
Sara Custódio
Tiago Colaço
Ricardo Santos
Pedro Sousa
Pedro Escada
Publikationsdatum
18.01.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 4/2020
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-020-05792-4

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