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Cholesteatoma

MedGen UID:
3043
Concept ID:
C0008373
Disease or Syndrome
Synonyms: Cholesteatoma (disease); Congenital cholesteatoma (type); Primary acquired cholesteatoma (type); Secondary acquired cholesteatoma (type)
SNOMED CT: Cholesteatoma (575006); Epidermoid cholesteatoma (575006); Cholesteatoma (363668000)
 
HPO: HP:0009797
Monarch Initiative: MONDO:0006530

Definition

Cholesteatoma is a benign but potentially destructive growth consisting of keratinizing epithelium located in the middle ear and/or mastoid process. In cholesteatoma, a skin cyst grows into the middle ear and mastoid. The cyst is not cancerous but can erode tissue and cause destruction of the ear. [from HPO]

Conditions with this feature

Marshall-Smith syndrome
MedGen UID:
75551
Concept ID:
C0265211
Disease or Syndrome
The Marshall-Smith syndrome (MRSHSS) is a malformation syndrome characterized by accelerated skeletal maturation, relative failure to thrive, respiratory difficulties, mental retardation, and unusual facies, including prominent forehead, shallow orbits, blue sclerae, depressed nasal bridge, and micrognathia (Adam et al., 2005).
Brain-lung-thyroid syndrome
MedGen UID:
369694
Concept ID:
C1970269
Disease or Syndrome
NKX2-1-related disorders range from benign hereditary chorea (BHC) to choreoathetosis, congenital hypothyroidism, and neonatal respiratory distress (also known as brain-lung-thyroid syndrome). Childhood-onset chorea, the hallmark of NKX2-1-related disorders, may or may not be associated with respiratory distress syndrome or congenital hypothyroidism. Chorea generally begins in early infancy or about age one year (most commonly) or in late childhood or adolescence, and progresses into the second decade after which it remains static or (rarely) remits. Pulmonary disease, the second most common manifestation, can include respiratory distress syndrome in neonates, interstitial lung disease in young children, and pulmonary fibrosis in older persons. The risk for pulmonary carcinoma is increased in young adults with an NKX2-1-related disorder. Thyroid dysfunction, the result of dysembryogenesis, can present as congenital hypothyroidism or compensated hypothyroidism. The risk for thyroid cancer is unknown and may not be increased. In one review, 50% of affected individuals had the full brain-lung-thyroid syndrome, 30% had involvement of brain and thyroid only, and 13% had isolated chorea only.
Intellectual disability, autosomal dominant 2
MedGen UID:
481472
Concept ID:
C3279842
Mental or Behavioral Dysfunction
Any autosomal dominant non-syndromic intellectual disability in which the cause of the disease is a mutation in the DOCK8 gene.
Branchiootorenal syndrome 1
MedGen UID:
1632634
Concept ID:
C4551702
Disease or Syndrome
Branchiootorenal spectrum disorder (BORSD) is characterized by malformations of the outer, middle, and inner ear associated with conductive, sensorineural, or mixed hearing impairment, branchial fistulae and cysts, and renal malformations ranging from mild renal hypoplasia to bilateral renal agenesis. Some individuals progress to end-stage renal disease (ESRD) later in life. Extreme variability can be observed in the presence, severity, and type of branchial arch, otologic, audiologic, and renal abnormality from right side to left side in an affected individual and also among individuals in the same family.
Warburg-cinotti syndrome
MedGen UID:
1677486
Concept ID:
C5193019
Disease or Syndrome
Warburg-Cinotti syndrome (WRCN) is characterized by progressive corneal neovascularization, keloid formation, chronic skin ulcers, wasting of subcutaneous tissue, flexion contractures of the fingers, and acroosteolysis (Xu et al., 2018).
Immunodeficiency 82 with systemic inflammation
MedGen UID:
1781752
Concept ID:
C5543581
Disease or Syndrome
Immunodeficiency-82 with systemic inflammation (IMD82) is a complex autosomal dominant immunologic disorder characterized by recurrent infections with various organisms, as well as noninfectious inflammation manifest as lymphocytic organ infiltration with gastritis, colitis, and lung, liver, CNS, or skin disease. One of the more common features is inflammation of the stomach and bowel. Most patients develop symptoms in infancy or early childhood; the severity is variable. There may be accompanying fever, elevated white blood cell count, decreased B cells, hypogammaglobulinemia, increased C-reactive protein (CRP; 123260), and a generalized hyperinflammatory state. Immunologic workup shows variable B- and T-cell abnormalities such as skewed subgroups. Patients have a propensity for the development of lymphoma, usually in adulthood. At the molecular level, the disorder results from a gain-of-function mutation that leads to constitutive and enhanced activation of the intracellular inflammatory signaling pathway. Treatment with SYK inhibitors rescued human cell abnormalities and resulted in clinical improvement in mice (Wang et al., 2021).

Professional guidelines

PubMed

Wei B, Zhou P, Zheng Y, Zhao Y, Li T, Zheng Y
Int J Pediatr Otorhinolaryngol 2023 Jan;164:111401. Epub 2022 Dec 8 doi: 10.1016/j.ijporl.2022.111401. PMID: 36512880
Dreizin D, Sakai O, Champ K, Gandhi D, Aarabi B, Nam AJ, Morales RE, Eisenman DJ
Radiographics 2021 May-Jun;41(3):762-782. Epub 2021 Apr 2 doi: 10.1148/rg.2021200189. PMID: 33797996
Olszewska E, Rutkowska J, Özgirgin N
J Int Adv Otol 2015 Apr;11(1):81-7. doi: 10.5152/iao.2015.1206. PMID: 26223725

Recent clinical studies

Etiology

Müller M, Honegger F, Podvinec M, Metternich F, Gürtler N
Eur Arch Otorhinolaryngol 2022 Mar;279(3):1203-1210. Epub 2021 Mar 24 doi: 10.1007/s00405-021-06744-2. PMID: 33760955
Yung M, Tono T, Olszewska E, Yamamoto Y, Sudhoff H, Sakagami M, Mulder J, Kojima H, İncesulu A, Trabalzini F, Özgirgin N
J Int Adv Otol 2017 Apr;13(1):1-8. Epub 2017 Jan 6 doi: 10.5152/iao.2017.3363. PMID: 28059056
Olszewska E, Rutkowska J, Özgirgin N
J Int Adv Otol 2015 Apr;11(1):81-7. doi: 10.5152/iao.2015.1206. PMID: 26223725
Kazahaya K, Potsic WP
Curr Opin Otolaryngol Head Neck Surg 2004 Oct;12(5):398-403. doi: 10.1097/01.moo.0000136875.41630.d6. PMID: 15377951
Zappia JJ, Wiet RJ
Arch Otolaryngol Head Neck Surg 1995 Jan;121(1):19-22. doi: 10.1001/archotol.1995.01890010007002. PMID: 7803017

Diagnosis

Castle JT
Head Neck Pathol 2018 Sep;12(3):419-429. Epub 2018 Aug 1 doi: 10.1007/s12105-018-0915-5. PMID: 30069838Free PMC Article
Rutkowska J, Özgirgin N, Olszewska E
J Int Adv Otol 2017 Aug;13(2):266-271. Epub 2017 Mar 9 doi: 10.5152/iao.2017.3411. PMID: 28274903
Yung M, Tono T, Olszewska E, Yamamoto Y, Sudhoff H, Sakagami M, Mulder J, Kojima H, İncesulu A, Trabalzini F, Özgirgin N
J Int Adv Otol 2017 Apr;13(1):1-8. Epub 2017 Jan 6 doi: 10.5152/iao.2017.3363. PMID: 28059056
Kuo CL, Shiao AS, Yung M, Sakagami M, Sudhoff H, Wang CH, Hsu CH, Lien CF
Biomed Res Int 2015;2015:854024. Epub 2015 Mar 18 doi: 10.1155/2015/854024. PMID: 25866816Free PMC Article
Bhutta MF, Williamson IG, Sudhoff HH
BMJ 2011 Mar 3;342:d1088. doi: 10.1136/bmj.d1088. PMID: 21372073

Therapy

Choong KWK, Kwok MMK, Shen Y, Gerard JM, Teh BM
ANZ J Surg 2022 May;92(5):994-1006. Epub 2022 Feb 22 doi: 10.1111/ans.17563. PMID: 35191151
Karanth TK, Whittemore KR
Auris Nasus Larynx 2018 Dec;45(6):1143-1151. doi: 10.1016/j.anl.2018.04.012. PMID: 29764722
Lee CH, Kim MK, Kim HM, Won C, Shin TH, Kim SY
Otol Neurotol 2018 Jun;39(5):e336-e341. doi: 10.1097/MAO.0000000000001803. PMID: 29649053
Ching HH, Spinner AG, Ng M
Int J Pediatr Otorhinolaryngol 2017 Nov;102:21-27. Epub 2017 Aug 25 doi: 10.1016/j.ijporl.2017.08.027. PMID: 29106870
Morris P
BMJ Clin Evid 2012 Aug 6;2012 PMID: 23870746Free PMC Article

Prognosis

Simmonds JC, Vecchiotti M
Int J Pediatr Otorhinolaryngol 2017 Sep;100:66-70. Epub 2017 Jun 22 doi: 10.1016/j.ijporl.2017.06.022. PMID: 28802389
Keller M, Sload R, Wilson J, Greene H, Han P, Wise S
Otolaryngol Head Neck Surg 2017 Dec;157(6):1025-1033. Epub 2017 Jul 4 doi: 10.1177/0194599817717486. PMID: 28675101
Holt JJ
Laryngoscope 2008 Nov;118(11):2036-9. doi: 10.1097/MLG.0b013e318182087f. PMID: 18818552
Kartush JM, Michaelides EM, Becvarovski Z, LaRouere MJ
Laryngoscope 2002 May;112(5):802-7. doi: 10.1097/00005537-200205000-00007. PMID: 12150610
Nishizaki K, Yamamoto S, Fukazawa M, Yuen K, Ohmichi T, Masuda Y
Int J Pediatr Otorhinolaryngol 1996 Feb;34(3):259-64. doi: 10.1016/0165-5876(95)01271-0. PMID: 8839077

Clinical prediction guides

Yang S, Farrell J, Ye S, Ahmad I, Valdez TA
J Biomed Opt 2023 Jun;28(6):066003. Epub 2023 Jun 16 doi: 10.1117/1.JBO.28.6.066003. PMID: 37334207Free PMC Article
Müller M, Honegger F, Podvinec M, Metternich F, Gürtler N
Eur Arch Otorhinolaryngol 2022 Mar;279(3):1203-1210. Epub 2021 Mar 24 doi: 10.1007/s00405-021-06744-2. PMID: 33760955
Semaan MT, Megerian CA
Otolaryngol Clin North Am 2006 Dec;39(6):1143-59. doi: 10.1016/j.otc.2006.08.003. PMID: 17097438
Kazahaya K, Potsic WP
Curr Opin Otolaryngol Head Neck Surg 2004 Oct;12(5):398-403. doi: 10.1097/01.moo.0000136875.41630.d6. PMID: 15377951
Hildmann H, Sudhoff H
Int J Pediatr Otorhinolaryngol 1999 Oct 5;49 Suppl 1:S81-6. doi: 10.1016/s0165-5876(99)00138-x. PMID: 10577781

Recent systematic reviews

Dżaman K, Czerwaty K, Reichert TE, Szczepański MJ, Ludwig N
Int J Mol Sci 2023 Jul 31;24(15) doi: 10.3390/ijms241512277. PMID: 37569652Free PMC Article
Illés K, Meznerics FA, Dembrovszky F, Fehérvári P, Bánvölgyi A, Csupor D, Hegyi P, Horváth T
Laryngoscope 2023 Jun;133(6):1297-1305. Epub 2022 Sep 28 doi: 10.1002/lary.30413. PMID: 36169349
Jennings BA, Prinsley P, Philpott C, Willis G, Bhutta MF
Clin Otolaryngol 2018 Feb;43(1):55-67. Epub 2017 Jun 1 doi: 10.1111/coa.12900. PMID: 28485112
Ching HH, Spinner AG, Ng M
Int J Pediatr Otorhinolaryngol 2017 Nov;102:21-27. Epub 2017 Aug 25 doi: 10.1016/j.ijporl.2017.08.027. PMID: 29106870
Morris P
BMJ Clin Evid 2012 Aug 6;2012 PMID: 23870746Free PMC Article

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