Biology of cholesteatoma: special considerations in pediatric patients

Cholesteatoma is a unique pathologic condition of the temporal bone characterized by migration of keratinized squamous epithelium positioned into the middle ear and mastoid cavity. The exact pathogenic molecular mechanisms behind the formation and propagation of cholesteatoma remain unclear. This review will aim to define the classification of cholesteatomas, review the most accepted pathogenesis theories, describe the inherent molecular mechanisms dictating the hyperproliferative nature of cholesteatoma keratinocytes, and explore innate biological differences between pediatric and adult cholesteatoma.