Objectives: To adopt a newly designed scoring/staging system for of tympanomastoid cholesteatoma similar to cancer staging protocols.
Methods: Our system relied on clinical, CT findings, and confirmed with intraoperative findings. All bony items that could be affected by cholesteatoma were scored, including: scutum (S), ossicles (O), mastoid (M), posterior canal wall (C), lateral sinus plate (L), inner ear (E), facial nerve canal (F), and tegmen (T). These items were termed collectively SOM CLEFT scoring system. A previous immunochemical study by authors validated our work.
Results: We staged cholesteatoma into 5 stages similar to cancer staging starting by stage 0: CIS (Cholesteatoma in situ) which means limited disease with no evidence of bone erosion and ended by stage IV which means cholesteatoma with intracranial complications and/or labyrinthitis, complete facial paralysis.
Conclusion: Our scoring/staging system is objective, broad, decisive, gives all merits of cancer staging and confirmed by an immunohistochemical study.