The prevalence of allergy in young children with an acquired cholesteatoma

Tange, R. A.; Grolman, Wilko; Woutersen, D.

doi:10.1016/s0385-8146(99)00059-0

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…Further research is warranted to establish a rational basis for surgical intervention as a preventive management strategy against acquired cholesteatoma, which might reduce the morbidity and health care costs associated with middle ear disease. 32…”

Section: Discussionmentioning

confidence: 99%

“…In a similar fashion, timely and appropriate intervention for CRS control may have an indirect beneficial effect of preventing irreversible cholesteatomatous pathology in the middle ear cleft. Further research is warranted to establish a rational basis for surgical intervention as a preventive management strategy against acquired cholesteatoma, which might reduce the morbidity and health care costs associated with middle ear disease …”

Section: Discussionmentioning

confidence: 99%

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Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis

Kuo

Yen

Chang

et al. 2017

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Chronic rhinosinusitis (CRS) can cause an obstruction of the tubal orifice and thereby compromise ventilation of the middle ear. The resulting negative pressure in the middle ear may, in turn, lead to the formation of an eardrum retraction pocket and subsequent acquired cholesteatoma. This study hypothesizes that CRS may increase the risk of cholesteatoma. OBJECTIVE To evaluate the risk of cholesteatoma in patients with CRS. DESIGN, SETTING, AND PARTICIPANTS This study used a nationwide, population-based claims database to test the hypothesis that CRS may increase the risk of cholesteatoma. The Longitudinal Health Insurance Database of Taiwan was used to compile data from (1) 12 670 patients with newly diagnosed CRS between January 1, 1997, and December 31, 2002, and (2) a comparison cohort of 63 350 matched individuals without CRS, resulting in a CRS vs control ratio of 1:5. Data analysis was performed from June 1 to October 27, 2015. Each patient was followed up for 8 years to identify those in whom cholesteatoma subsequently developed. The Kaplan-Meier method was used to determine the cholesteatoma-free survival rate, and the log-rank test was used to compare survival curves. Cox proportional hazards regression models were used to compute the 8-year hazard ratios (HRs). MAIN OUTCOMES AND MEASURES Diagnosis of cholesteatoma. RESULTS Among the 76 020 patients enrolled in this study, 35 220 (46.3%) were female; mean (SD) age was 27.57 (22.03) years. A total of 209 patients developed cholesteatoma, 66 (101 084 person-years) individuals from the CRS cohort and 143 (506 540 person-years) from the comparison cohort were diagnosed with cholesteatoma during the 8-year follow-up period. The incidence of cholesteatoma per 1000 person-years was more than twice as high among patients with CRS (0.65; 95% CI, 0.50-0.81 person-years) than among those without CRS (0.28; 95% CI, 0.24-0.33). The absolute difference in the incidence density between CRS and non-CRS group was 0.37 (95% CI, 0.21-0.53) per 1000 patient-years. After adjusting for potential confounders, patients with CRS had a 69% increased risk of cholesteatoma within 8 years, compared with those without CRS (HR, 1.69; 95% CI, 1.23-2.32). Patients with CRS presented a significantly lower 8-year cholesteatoma-free survival rate than did those in the comparison group. The absolute difference in the 8-year cholesteatoma-free survival rate between the CRS and non-CRS groups was 0.0029 (95% CI, 0.0016-0.0043). CONCLUSIONS AND RELEVANCE This is the first large-scale study, to date, to demonstrate a prospective link between CRS and the subsequent development of cholesteatoma within a follow-up period of 8 years. The purpose of the study was to draw attention to the possibility of development of cholesteatoma among patients with CRS. Because that possibility exists, clinicians should keep this association in mind as well as the importance of a thorough head and neck examination.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis

Kuo

Yen

Chang

et al. 2017

JAMA Otolaryngol Head Neck Surg

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“…Our search identified 449 unique studies, of which 36 met the initial inclusion criteria. Most studies were excluded at the abstract or primary manuscript review stage, but six manuscripts were excluded at the data extraction stage because there were no relevant primary data identified about cholesteatoma or genetic phenomena, or because the study described external auditory canal cholesteatoma . The studies identified in the initial search were supplemented by five additional reports identified by hand‐searching citation lists .…”

Section: Resultsmentioning

confidence: 99%

The genetics of cholesteatoma. A systematic review using narrative synthesis

Jennings

Prinsley

Philpott

et al. 2017

Clinical Otolaryngology

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Objective: A cholesteatoma is a mass of keratinising epithelium in the middle ear. It is a rare disorder that is associated with significant morbidity, and its causative risk factors are poorly understood; on a global scale, up to a million people are affected by this each year. We have conducted a systematic literature review to identify reports about the heritability of cholesteatoma or any constitutional genetic factors that may be associated with its aetiology.Data Sources: A systematic search of MEDLINE (EBSCO) and two databases of curated genetic research (OMIM and Phenopedia) was conducted.Study Selection: The participants and populations of interest for this review were people treated for cholesteatoma and their family members. The studies of interest reported evidence of heritability for the trait, or any association with congenital syndromes and particular genetic variants.Data Extraction: The searches identified 449 unique studies, of which 35 were included in the final narrative synthesis.Data Synthesis: A narrative synthesis was conducted, and data were tabulated to record characteristics, including study design, genetic data and author conclusions.Most of the studies identified in the literature search, and described here, are case reports and so represent the lowest level of evidence. In a few case reports, congenital and acquired cholesteatomas have been shown to segregate within families in the pattern typical of a monogenic or oligogenic disorder with incomplete penetrance. Evidence from syndromic cases could suggest that genes controlling ear morphology may be risk factors for cholesteatoma formation.Conclusions: This is the first systematic review about the genetics of cholesteatoma, and we have identified a small body of relevant literature that provides evidence of a heritable component for its aetiology. Cholesteatoma is a complex and heterogeneous clinical phenotype, and it is often associated with chronic otitis media and with some rare congenital syndromes known to affect ear morphology and related pathologies.

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“…Mattucci and Greenfield further identified Eustachian tube dysfunction as a common factor in the pathogenesis of middle ear diseases, in which the role of allergens is significant . Tange et al reported a high prevalence of positive results in the multiantigen radioallergosorbent test among young children with acquired cholesteatoma, thereby identifying allergy as a comorbidity factor in the pathogenesis of cholesteatoma . Finally, Lazo‐Sáenz et al reported that AR patients have a higher risk of Eustachian tube dysfunction .…”

Section: Discussionmentioning

confidence: 99%

“…They found that many patients with a Eustachian tube obstruction who fail to respond favorably to traditional medical and surgical management can benefit from specific allergy therapies (i.e., immunotherapy and diet). Further research is warranted to establish a firmer rational basis for the use of anti‐allergy therapy as a preventive management strategy against cholesteatoma, which could conceivably reduce morbidity and healthcare costs associated with middle ear diseases …”

Section: Discussionmentioning

confidence: 99%