ADVANCES IN THE DIAGNOSIS AND SURGICAL MANAGEMENT OF CHOLESTEATOMA: A CONTEMPORARY REVIEW
TL;DR
Current advances in the diagnosis and surgical management of cholesteatoma are presented, with particular emphasis on modern imaging techniques, endoscopic ear surgery, and applications of artificial intelligence.
Abstract
Cholesteatoma is a chronic, locally destructive disease of the middle ear characterized by the presence of keratinizing stratified squamous epithelium within the tympanic cavity and mastoid process. Despite its histologically benign nature, it may lead to the destruction of bony structures, damage to the auditory ossicles, and the development of serious intra- and extracranial complications. Its complex pathogenesis and tendency to recur make cholesteatoma a significant diagnostic and therapeutic challenge. In recent years, substantial progress has been made in both the diagnosis and surgical treatment of cholesteatoma. High-resolution computed tomography and magnetic resonance imaging with non-echo-planar diffusion-weighted imaging (non-EPI DWI) sequences enable accurate assessment of primary, residual, and recurrent lesions. Surgical treatment remains the cornerstone of therapy, while advances in endoscopic techniques have improved visualization of anatomical structures and enhanced surgical effectiveness while reducing invasiveness. Artificial intelligence systems are also gaining increasing importance in supporting imaging analysis, treatment planning, and clinical decision-making. The aim of this review is to present current advances in the diagnosis and surgical management of cholesteatoma, with particular emphasis on modern imaging techniques, endoscopic ear surgery, and applications of artificial intelligence. The development of these technologies may contribute in the future to improved treatment outcomes and reduced risk of disease recurrence.