Athanasopoulos Michail, Samara Pinelopi, Mastronikolis Stylianos, Mastronikoli Sofianiki, Danielides Gerasimos, Lygeros Spyridon
Department of Otolaryngology, University Hospital of Patras, 26504 Patras, Greece.
Children's Oncology Hospital Marianna V. Vardinoyannis-ELPIDA, 11527 Athens, Greece.
Diagnostics (Basel). 2025 Jun 8;15(12):1461. doi: 10.3390/diagnostics15121461.
Cholesteatoma, characterized by the abnormal growth of keratinizing squamous epithelium in ectopic locations, most commonly arises in the middle ear. Its occurrence in the sinonasal tract is rare and presents significant diagnostic and management challenges. These lesions can lead to severe complications like bone erosion, intracranial involvement, and orbital spread. This narrative review aims to summarize the current knowledge on cholesteatomas in these regions, focusing on epidemiology, pathophysiology, diagnosis, and treatment. A comprehensive review of the English literature was conducted, focusing on reported cases of cholesteatomas in the nasal cavity and paranasal sinuses. This review examines key aspects, including epidemiological data, imaging findings, surgical strategies, and postoperative outcomes. The role of diagnostic tools, particularly computed tomography and diffusion-weighted magnetic resonance imaging, in distinguishing cholesteatomas from other sinonasal lesions is also discussed. As of March 2025, 51 cases of paranasal sinus cholesteatoma were reported. The frontal sinus is the most commonly affected site, followed by the maxillary, ethmoid, and sphenoid sinuses. Diagnosis is often delayed due to nonspecific symptoms, such as nasal congestion and recurrent infections. Surgical excision is the primary treatment, with endoscopic techniques being favored for their minimally invasive nature. Recurrence remains a major concern, and although very rare, cases of squamous cell carcinoma have also been observed in association with cholesteatoma. Nasal and paranasal sinus cholesteatomas require early recognition and intervention to prevent complications. Advances in imaging and surgery have improved outcomes; however, further research is needed to refine therapies and understand disease mechanisms.
胆脂瘤的特征是角化鳞状上皮在异位部位异常生长，最常见于中耳。其发生于鼻旁窦道的情况罕见，且在诊断和治疗方面存在重大挑战。这些病变可导致严重并发症，如骨质侵蚀、颅内累及和眼眶扩散。本叙述性综述旨在总结目前关于这些区域胆脂瘤的知识，重点关注流行病学、病理生理学、诊断和治疗。对英文文献进行了全面综述，重点关注鼻腔和鼻旁窦胆脂瘤的报告病例。本综述考察了关键方面，包括流行病学数据、影像学表现、手术策略和术后结果。还讨论了诊断工具，特别是计算机断层扫描和扩散加权磁共振成像，在区分胆脂瘤与其他鼻旁窦病变中的作用。截至2025年3月，共报告了51例鼻旁窦胆脂瘤病例。额窦是最常受累的部位，其次是上颌窦、筛窦和蝶窦。由于鼻塞和反复感染等非特异性症状，诊断往往延迟。手术切除是主要治疗方法，内镜技术因其微创性而受到青睐。复发仍然是一个主要问题，并且虽然非常罕见，但也观察到与胆脂瘤相关的鳞状细胞癌病例。鼻腔和鼻旁窦胆脂瘤需要早期识别和干预以预防并发症。影像学和手术方面的进展改善了治疗结果；然而，需要进一步研究以优化治疗方法并了解疾病机制。
