We have undertaken the analysis of the specific clinical manifestations of acquired cholesteatoma of the middle ear in 437 chronic patients suffering from this pathology. 96.1% of them presented with primarily acquired cholesteatoma of the middle ear (including 53.3% having attic cholesteatoma, 22.8% with sinus cholesteatoma, and 19.9% of tensa retraction cholesteatoma). 3.9% of the patients exhibited a different mechanism of development of cholesteatoma. The secondary acquired mesotympanic cholesteatoma formed in association with the long-term chronic inflammation of the middle ear, concomitant perforation of the tympanic membrane and epithelial invasion from the edge of the tympanic membrane perforation and middle ear cavity. Typmanosclerosis of different degree and localization played an important role in the enhancement of the prevalence of this condition. All types of acquired cholesteatoma were found to extend beyond the point of origin of the disorder. The maximum destruction of the ossicular chain was documented in the patients presenting with sinus cholesteatoma. Those with secondary acquired cholesteatoma showed the worst functional capacity as a result of rigid fixation of the auditory ossicles. The overall cholesteatoma relapse rate (including both residual and recurrent cholesteatoma) was estimated to be 15.6%. It is concluded that the surgical strategy should be chosen on an individual basis for each concrete patient. The long-term observation of the treated patients with the application of the up-to-date radiological techniques is believed to be the indispensable prerequisite for the successful management of the complicated pathology under consideration.

This article provides a brief literature review of national and foreign authors’ works, presenting a brief historical sketch of the study of the middle ear cholesteatoma. The authors present cholesteatoma definition from the viewpoint of V. F. Undrits, L. T. Levin, V. T. Palchun, I. Friedmann, H. Schuknecht and other domestic and foreign authors. The article describes the modern concepts of its macroscopic and microscopic structure, giving coverage to the currently existing classifications. The authors consider the theories of the etiology and pathogenesis of congenital and acquired middle ear cholesteatoma.

This article provides a brief literature review on congenital cholesteatoma of the temporal bone. Existing theories describing the development of this pathology are analysed. The diagnostic criteria of congenital cholesteatoma are presented, along with a comparative analysis of the characteristics of various instrumental research methods used in the verification of this disease. Issues involved with the surgical management of such patients are considered.A conclusion is made that, due to the rare occurrence of the congenital cholesteatoma of the temporal bone, diverse theories of its etiology, the lack of clear criteria for its diagnostics, this pathology requires further research to elucidate the nature of the disease and identify the risk groups of its occurrence.Conflict of interest: the authors declare no conflict of interest.

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The article presents the clinical observation of 12 patients with chronic suppurative otitis media complicated with petrous pyramid cholesteatoma. According to the Moffat­Smith 2008 classification, the following types of petrous pyramid cholesteatoma propagation have been revealed: supralabyrinthine (n = 1), supralabyrinthine – apical (n = 2), infralabyrinthine (n = 4), infralabyrinthine – apical (n = ­3), massive (n = ­1) and massive­apical (n = ­1). We analyzed the clinical aspects of each post-surgery patient and surgical approaches of petrous pyramid cholesteatoma excision and the final result of surgical treatment. It has been noted that in infralabyrinthine petrous pyramid cholesteatoma no facial nerve damage which manifests itself in the form of mimic muscles paresis (paralysis) is observed unlike the supralabyrinthine type of cholesteatoma. The incidence of petrous pyramid cholesteatoma is 0.2%.