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Review
. 2016 Dec;9(4):298-308.
doi: 10.21053/ceo.2015.01662. Epub 2016 Jul 21.

Pathogenesis and Bone Resorption in Acquired Cholesteatoma: Current Knowledge and Future Prospectives

Mahmood A Hamed  1   2 , Seiichi Nakata  1 , Ramadan H Sayed  2 , Hiromi Ueda  3 , Badawy S Badawy  2 , Yoichi Nishimura  1 , Takuro Kojima  1 , Noboru Iwata  1 , Ahmed R Ahmed  4 , Khalid Dahy  2 , Naoki Kondo  5 , Kenji Suzuki  1   6
Affiliations
Review

Pathogenesis and Bone Resorption in Acquired Cholesteatoma: Current Knowledge and Future Prospectives

Mahmood A Hamed et al. Clin Exp Otorhinolaryngol. 2016 Dec.

Abstract

Cholesteatoma is a cystic non tumorous lesion of the temporal bone that has the ability to destroy nearby structures by its power to cause bone resorption and as a result, fatal complications prevail. We aimed to conduct a comprehensive review for pathogenesis of acquired cholesteatoma, bone resorption mechanisms, and offer a future vision of this serious disease. We have reviewed different theories for pathogenesis of acquired cholesteatoma including the most relevant and updated ones with special emphasis on the mechanisms of bone resorption through Medline/PubMed research using the keywords 'aetiopathogenesis, bone resorption, acquired cholesteatoma, temporal bone, and cytokines.' In order to strengthen our study, we searched the reference lists of identified reviews. Cholesteatoma is a subject of debate among otolaryngologists since it was prescribed firstly. Over many decades, several theories were postulated for aetiopathogenesis of cholesteatoma with a tendency to follow more than one theory to explain the proper nature of that disease. Until now, the mechanism of bone resorption has yet to be more clarified. In the last century, a leap has occurred in the field of biomolecular cholesteatoma research which improved our knowledge about its pathophysiology and bone destructive mechanism. However, surgery is still the only available treatment. We conclude that discovery of new therapeutic choices for cholesteatoma other than surgery by the use of anti-growth, anti-proliferative, apoptotic agents as well as medications that antagonize osteoclastogenesis should be the main concern in the future clinical and experimental research work. Also, searching for predictors of the aggressiveness of cholesteatoma can affect the timing of intervention and prevent occurrence of complications.

Keywords: Acquired; Bone Resorption; Cholesteatoma; Cytokines; Pathogenesis; Temporal Bone.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Methods of papers’ selection in our review.
Fig. 2.
Fig. 2.
Left cholesteatomatous otitis media complicated by left lateral canal fistula (arrow).
See this image and copyright information in PMC

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