Proposed Clinical Classification of Cholesteatoma

This study presents a preliminary trial for a new classification of cholesteatoma that allow comparison of cases and standardization of management. All previous attempts failed to gain acceptance because of the lack of clinical relevance. Objective: Trial of a new simple practical system to stage cholesteatoma based only on the extent of the lesion, utilizing microscopic and endoscopic examination with thin cuts CT scan. Study design: A prospective study, from September 2007 to September 2008. All patients with cholesteatoma (32 ears) admitted during this period were graded according to our new grading system preoperatively and intra-operatively. The surgeon was blind as regards the preoperative grading. Comparison of the preoperative with the intra-operative grading was done. Results: The preoperative grading was correct compared to the intra-operative grading in 75% of cases. This demonstrates the potential value of this grading system. Conclusion: Classification of cholesteatoma depending only on the clinical and radiological extension of the disease is practical and can be easily applied in order to be able to standardize management and compare published data. This grading could be applied mainly in comparing non-functional results (i.e. recurrence of the cholesteatoma). ORIGINAL ARTICLE