Aural Cholesteatoma (Tympanokeratoma) in Veterinary Medicine: An Update and Principles of Clinical Management.

Endoscopy-assisted approaches show superior outcomes versus conventional surgery for cholesteatoma.

Aural cholesteatoma (tympanokeratosis) is a destructive epidermoid cyst arising within the temporal bone that was historically rare in veterinary medicine but has increased in reported incidence. This comprehensive review synthesizes epidemiological, etiological, and clinical management data across veterinary species, with over 200 documented canine cases plus reports in cats, gerbils, and rabbits. Brachycephaly and otitis externa emerge as predisposing factors in dogs, with a potential emerging association with aural polyps in both dogs and cats. The study proposes the first clinical staging scheme and treatment principles for companion animals. Notably, evidence does not support radiation therapy as a primary treatment modality. Endoscopy-assisted nonsurgical and surgical approaches demonstrate lower clinical relapse rates compared to conventional surgical techniques. The authors emphasize the importance of minimally invasive approaches for improved outcomes. Despite these advances, significant gaps remain in the literature, and future investigations are needed to validate or refine the proposed staging and treatment recommendations for optimal clinical management.

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