[Recurrence of the pyramid of the temporal bone cholesteatoma: systematic review of literature].

UNLABELLED: This article analyzes the literature for the last 15 years from the PubMed, eLibrary, Google Scholar databases devoted to the topic of petrous bone cholesteatoma (PBC) and its recurrence. Taking into account the designated criteria, out of 530 articles, 16 publications written on the topic of PBCs were included in the study. The total number of patients was 970. In all publications Sanna classification was used. The types of surgical approaches, surgery endings, the presence of postoperative complications, the use of additional equipment and the frequency of recurrence were analyzed. The study identified factors for the recurrence of PBCs, and identified unresolved issues of recurrence that require attention.

OBJECTIVE: To study the data and results of surgical treatment of PBCs in the world literature, to study the factors and possible causes of recurrence of PBCs. Generalization of the obtained data, their systematization.

MATERIAL AND METHODS: A systematic literature search of databases (PubMed, Google Scholar, eLibrary) was conducted to identify articles from 2010 to 2025. Medical Subject Headings (MeSHTerms) and keywords were used as the search strategy petrous bone OR petrous[AllFields] AND bone[AllFields]) OR petrous bone[AllFields]) AND (cholesteatoma[MeSHTerms] OR cholesteatoma[AllFields] OR cholesteatomas[AllFields])). In eLibrary, the search was performed using the query petrous bone cholesteatoma. The search was limited to articles in English and Russian.

RESULTS: Of the 530 articles devoted to the topic of petrous bone cholesteatoma and its recurrence, repeated publications and works performed by the same group of authors were excluded from the study at the data search stage; publications were also excluded for other reasons (in total, n=456). The inclusion criteria for the study were defined in the database of patients with petrous bone cholesteatoma of the presented series: the number of patients should be more than 10, the use of the PBCs classification according to Sanna from 2016, performed surgical approach, recurrence rate, time of observation. Taking into account the listed criteria, 16 publications were included in the study. The total number of patients was 970. The distribution of PBCs extension: supralabyrinthine (SL) 50.7%, then massive (M) 25.8%, infralabyrinthine (IL) 8.4%, infralabyrinthine apical (ILA) 8.2%, apical (A) 6.8%. The most common surgical options were transotic approach (TO) - 201, translabyrinthine approach (TL) - 165, modified transcholear approach (MTC) - 96. The types of complications and their frequency of occurrence, options for surgery ending and the impact of these factors on the recurrence of PBCs were analyzed. The recurrence rate in the 16 publications studied ranged from 1.6% to 29%.

CONCLUSION: The causes of recurrence of PBCs are multifactorial. It is important to take into account the type of lesion, surgical approach using additional equipment, and the surgery ending. In the 16 described series of clinical cases the average incidence of recurrence of PBCs is 13.8%, with 50% of the recurrent lesions in the supralabyrinthine type. It is impossible to establish a causal relationship between the recurrence of PBCs due to the fact that the studied literature does not have enough data to conduct a meta-analysis. The problem of recurrent PBCs requires further studies, accumulation of experience, presentation of the obtained results, and a search for a relationship between recurrence and the factors that determine it.