Identification of risk factors for residual cholesteatoma in children and adults: a retrospective study on 110 cases of revision surgery

Volgger, Veronika; Lindeskog, Göran; Krause, Eike; Schrötzlmair, Florian

doi:10.1016/j.bjorl.2018.11.004

Cited by 9 publications

(12 citation statements)

References 32 publications

(54 reference statements)

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“…The recurrence rates of this study, which were 23.3 per cent in adults and 45.5 per cent in children, are in line with previous literature. 3,4,6,7 Despite the acknowledged importance of an experienced surgeon, the operating surgeon was not identified as a risk factor for recurrence in our study. 3 We were able to identify childhood and a low tegmen as risk factors for recurrence, especially when both these risk factors are present.…”

Section: Discussionmentioning

confidence: 68%

“…3,4,6,7 Despite the acknowledged importance of an experienced surgeon, the operating surgeon was not identified as a risk factor for recurrence in our study. 3 We were able to identify childhood and a low tegmen as risk factors for recurrence, especially when both these risk factors are present. Previous research showed that cholesteatomas are more aggressive in children than in adults; this is in line with our results.…”

Section: Discussionmentioning

confidence: 68%

“…In order to assess cholesteatoma size, the middle ear was divided into eight compartments: hypotympanum, protympanum, mesotympanum, epitympanum, sinus tympani, facial recess, antrum and mastoid. 3 The cholesteatoma could be present at multiple locations, depending on its size.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, a low tegmen has not been identified as a risk factor for recurrence until now. 3,9 It is known that exposure of the protympanum and anterior epitympanum may be challenging in a canal wall up procedure. 10 It is possible that inadequate visualisation, resulting from a low tegmen, can lead to a residual cholesteatoma.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 It is a common health problem, with an incidence of 9.2 per 100 000 in adults and 3 per 100 000 in children. 3 If undetected and untreated, cholesteatoma may lead to significant complications associated with the destruction of temporal bone structures. 3 This can result in conductive and sensorineural hearing loss, cranial invasion (leading to brain abscess or meningitis), and, in some cases, facial nerve paralysis.…”

Section: Introductionmentioning

confidence: 99%

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Determinants influencing cholesteatoma recurrence in daily practice: a retrospective analysis

2022

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Background Cholesteatoma is a benign but destructive epithelial lesion in the middle ear and/or mastoid. It is hard to translate data from previous research to daily clinical practice. In this study, factors influencing recurrence rates in daily clinical practice were identified. Method The study included 67 patients who were treated for a cholesteatoma with combined approach tympanoplasty. The average follow-up time was 35 months. Results The recurrence rate was 23.3 per cent in adults and 45.5 per cent in children. Predictors of recurrence were younger age and a low tegmen. A cholesteatoma in a child and the simultaneous presence of a low tegmen led to recurrence in 82.8 per cent of the patients. Conclusion Patients – especially children – with a low tegmen have an increased risk of recurrence. It is recommended that ENT surgeons be aware of recurrence in children, particularly in the case of a low tegmen.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Determinants influencing cholesteatoma recurrence in daily practice: a retrospective analysis

2022

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Mastoid Obliteration Decreases the Recurrent and Residual Disease: Systematic Review and Meta‐analysis

et al. 2022

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Objective: Our study aims to evaluate the effectiveness of mastoid obliteration compared to the canal wall up (CWU) technique in cholesteatoma surgery based on the systematic review of the literature and the meta-analysis of the data.Methods: The systematic search was performed in four major databases (MEDLINE, Web of Science, Embase, and CENTRAL) on October 14, 2021. Studies comparing the CWU technique and mastoid obliteration were included. The exclusion criteria were less than 12 months follow-up, congenital cholesteatoma, indefinite description of the surgical method, and animal studies. The protocol was registered on Prospero (registration number: CRD42021282485). The risk of bias was evaluated with the ROBINS-I tool. Residual and recurrent disease proportions as primary outcomes, quality of life, ear discharge, infection rates, hearing results, and operation time as secondary outcomes were analyzed. In the quantitative synthesis, the random effect model was used, and heterogeneity was identified.Results: A total of 11 articles with 2077 operations' data were found eligible. All the identified studies were retrospective cohorts. The odds of pooled residual and recurrent disease proportion were significantly lower in the obliteration group compared to CWU (OR = 0.45, CI:0.28;0.80, p = 0.014). However, when separated, the proportion of ears with recurrent (OR = 0.41, CI:0.11;1.57, p = 0.140) or residual (OR = 0.59, CI:0.23, 1.50, p = 0.207) disease did not show a significant difference, even though the odds were quite similar. The qualitative synthesis identified no significant difference in the secondary outcomes, but obliteration elongated the operation time.Conclusion: Mastoid obliteration significantly decreased the proportion of residual and recurrent cholesteatoma in pooled analyses compared to the CWU technique with low-quality of data.

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Principles of Surgical Management of Cholesteatoma

Kaufman,

Santa Maria

2023

Textbook of Otitis Media

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Identification of risk factors for residual cholesteatoma in children and adults: a retrospective study on 110 cases of revision surgery

Cited by 9 publications

References 32 publications

Determinants influencing cholesteatoma recurrence in daily practice: a retrospective analysis

Determinants influencing cholesteatoma recurrence in daily practice: a retrospective analysis

Mastoid Obliteration Decreases the Recurrent and Residual Disease: Systematic Review and Meta‐analysis

Principles of Surgical Management of Cholesteatoma

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