Update on cholesteatoma
Reviewed by Sangeeta Maini and Bhaskar Ram

Surgery for cholesteatoma should be tailored to individual patients, considering patient and disease factors, to obtain a dry, safe and functional ear. In this article, the authors discuss the current definitions and classification system of middle ear cholesteatoma, as well as the main principles and popular approaches to surgical management. The EAONO / JOS classification and staging system provides a valuable framework for data collection, and outcome assessment was explained. The canal wall up (CWU) and canal wall down (CWD) surgical approaches each have their advantages and disadvantages, and pros and cons of each approach were discussed. Mastoid obliteration techniques are mentioned and the variations using autografts and various other materials which require further standardisation are discussed. There is mention of endoscopic ear surgery which certainly augments our surgical visualisation and assists in eradicating cholesteatoma. The authors rightly suggest long-term surveillance is essential due to the high recurrence rate and potential for serious complications. We feel that it is a good comprehensive read for young otologists / trainees.

Principles of Cholesteatoma Management.
Angeli SI, Chang KW.
OTOLARYNGOL CLIN NORTH AM
2025;58(1):41–50.