• Salah Mansour
  • Jacques Magnan
  • Karen Nicolas
  • Hassan Haidar


Cholesteatoma of the middle ear is one of the most complex topics in otology; it is a chronic otitis media with the proliferation of “a wrong skin in the wrong place”.

In this chapter a comprehensive overview of this pathology with the most recent advances relative to its pathogenesis is discussed. Pertinent light- and electron microscopic histopathology along with its related molecular biology and the potential genetic factors are reported. Bone resorption mechanisms in cholesteatoma are explained. Cholesteatoma is described according to its site of origin and its growth pathways. The accurate clinical assessment is detailed.

The staging system of cholesteatoma is represented according to the recent EAONO/JOS Classification. The major contribution of imaging with CT scan is illustrated; especially to demonstrate cholesteatoma extension to the sites of difficult access (S1: anterior epitympanum, S2: sinus tympani). Also the MRI input in cholesteatoma is considered.

Cholesteatoma management being until now exclusively surgical, the main procedures are presented in detail with their correspondent advantages and disadvantages. Although the canal wall up technic responds best to the main objectives of nowadays strategies, special attention is reserved to pediatric cholesteatoma.

Follow up of cholesteatoma is a life time responsibility, so relative algorithms are proposed. Follow up by advanced MRI technics becoming more and more reliable, CWU is nowadays the procedure of choice for cholesteatoma surgery.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Salah Mansour
    • 1
  • Jacques Magnan
    • 2
  • Karen Nicolas
    • 3
    • 4
  • Hassan Haidar
    • 5
  1. 1.Lebanese University, Department of OtolaryngologyHNS Amoudi Center Boulevard MazraaBeirutLebanon
  2. 2.Aix-Marseille UniversityMarseilleFrance
  3. 3.Department of RadiologyMiddle East Institute of HealthBsalimLebanon
  4. 4.Lebanese UniversityBeirutLebanon
  5. 5.Department of OtolaryngologyHamad Medical Corporation, Weill Cornell Medical CollegeDohaQatar

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