Has the increasing use of grommets influenced the frequency of surgery for cholesteatoma?

Abstract

The number of operations for cholesteatoma, together with the number of cases undergoing insertion of ventilation tubes in the Tayside region of Scotland between 1966 and 1986 have been studied. During this period there has been a sixty fold increase in the use of ventilation tubes, but the incidence of cholesteatoma surgery has only varied between 0.94 and 1.88 operations per 10,000 of population per year. The mean annual incidence of cholesteatoma during this period was 1.32 cases per 10,000 of population. The results indicate that there has been neither a rise nor a fall in the incidence of cholesteatoma in Tayside despite a considerable increase in the use of ventilation tubes.

Time trend analysis of mastoidectomy procedures performed in Ontario, 1987–2007

“…While our study concurs with most of the previous population-adjusted studies, except for the Tayside region of Scotland, which demonstrated no change in cholesteatoma surgery rate between 1966 and 1986 [5], we are no closer to understanding the reason behind this decline. Acquired cholesteatomas occur as a result of progression of a retraction pocket into a non-self-cleaning pocket, accumulating keratin debris.…”

“…However, Padgham et al demonstrated no change in cholesteatoma formation despite a 60-fold increase in ventilation tube insertions [5]. During the decrease in cholesteatoma surgery from 1982 to 1991 in regional Finland, Kemppainen et al noted that the ventilation tube insertion rates were unchanged [1].…”

“…However, these data were not adjusted for population increases. Padgham et al studied both the cholesteatoma surgery and ventilation tube insertion rates in the Tayside region of Scotland between 1966 and 1986 [5]. They reported no change in the annual incidence of cholesteatoma surgery rate despite a 60-fold increase in ventilation tube insertions.…”

Cholesteatoma in Danish children – A national study of changes in the incidence rate over 34 years

“…Previous studies are however contradictory; Rakover et al found a decrease in the incidence rates of cholesteatoma surgery (adults included) after the ventilation tube insertion was started in Israel [11]. Padgham et al, found no change in the incidence rate of cholesteatoma surgery in children, despite a sixty-fold increase in the number of inserted ventilation tubes [12]. Drawing a firm conclusion on ecologic studies is injudicious, and further studies are needed to illuminate this issue.…”

Epidemiology of middle ear and mastoid cholesteatomas: study of 1146 cases

“…Padgham et al 14 found an annual incidence of 13 cholesteatomas per 100,000 inhabitants/year from 1966 to 1986 in Scotland. Homoe & Bretlau 15 found cholesteatomas in 35 Greenlandic Inuit in 756 operations for chronic otitis media in Greenland from 1976 to 1991.…”