Spontaneous Resolution of Cholesteatoma in a Patient on Long-Term Infliximab

Ann Otol Rhinol Laryngol. 2019 Apr;128(4):365-368. doi: 10.1177/0003489418823790. Epub 2019 Jan 11.


Objective:: To describe an observed case of spontaneous regression of cholesteatoma in a patient on chronic anti-tumor necrosis factor-alpha (TNF-a) therapy and inspire further research into the role of TNF-a in cholesteatoma.

Methods:: Clinical assessment of disease in a single-patient case report.

Results:: A 49-year-old woman suffered a severe case of Stevens-Johnson syndrome when she was 12 years old, leaving her with bilateral corneal opacification and tympanic membrane perforations with extensive cholesteatoma. For her corneal opacification, a corneal prosthesis was placed, which was complicated by a foreign body reaction necessitating long-term therapy with infliximab, a monoclonal antibody against TNF-a that is therapeutic in some chronic inflammatory diseases. She was otherwise healthy and took no other medications. While on infliximab, the patient had spontaneous and complete resolution of her cholesteatoma without any surgical intervention.

Conclusions:: This surprising case suggests that there may be a prominent role of TNF-a in cholesteatoma pathophysiology and that TNF-a may be an effective target for nonsurgical therapy.

Keywords: Miscellaneous; TNF-alpha antibody; cholesteatoma; chronic otitis media; infliximab; otolaryngology; otology; temporal bone CT.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal
  • Cholesteatoma* / complications
  • Cholesteatoma* / diagnosis
  • Cholesteatoma* / physiopathology
  • Cholesteatoma* / therapy
  • Corneal Opacity / etiology
  • Drug Repositioning
  • Female
  • Foreign-Body Reaction / complications
  • Foreign-Body Reaction / drug therapy*
  • Humans
  • Infliximab / administration & dosage*
  • Middle Aged
  • Ophthalmologic Surgical Procedures / adverse effects
  • Ophthalmologic Surgical Procedures / instrumentation
  • Ophthalmologic Surgical Procedures / methods
  • Prosthesis Implantation / adverse effects*
  • Prosthesis Implantation / instrumentation
  • Prosthesis Implantation / methods
  • Remission, Spontaneous
  • Stevens-Johnson Syndrome / complications
  • Temporal Bone / diagnostic imaging*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors


  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha
  • Infliximab