clinical and surgical features of acquired middle ear cholesteatoma: a 10 years population-based study

Background: cholesteatomas are benign destructive lesions of the temporal bone that may lead to life-threatening complications. objectives: this study described the clinical and surgical characteristics of chronic otitis media patients with acquired middle ear cholesteatoma. methods: among 1790 patients with chronic otitis media detected during almost 10 years, 449 suffered from cholesteatoma. the clinical features and surgical data were investigated. results: among the chronic otitis media patients, 449 (25.0%) cases had cholesteatoma with a mean age of 32.2 ± 16.1 sd years, and 62.8% were male. the most common symptom was otorrhea (53%), followed by hearing impairment (37.9%). erosion of the facial nerve canal was observed in 33.1% of patients, dural plate erosion in 4.8% of cases, and labyrinthine fistula in 10.3% of patients. moreover, ossicular chain erosion was observed with the highest frequency in incus (40%), followed by malleus (33%) and stapes (26%). amongst the surgically treated patients, 59.3% underwent mastoidectomy with canal wall preservation, 29.7% underwent modified radical mastoidectomy, and radical mastoidectomy was performed in 11% of patients. conclusions: cholesteatoma was seen in about a quarter of patients with chronic otitis media. based on our findings, cholesteatoma can be associated with serious complications such as facial nerve canal erosion (33.1%), dural plate erosion (4.8%), and labyrinthine fistula (10.3%). regarding the functional importance of the hearing system and the high prevalence of disease complications, middle ear cholesteatoma needs long-term follow-up.