Predictors of hearing improvement in patients with middle ear cholesteatoma
- Authors: Tarasova O.Y.1, Kosyakov S.Y.1
-
Affiliations:
- FSBEI FPE «Russian Medical Academy of Continuous Professional Education» MOH Russia
- Pages: 69-86
- Section: Научные исследования
- URL: https://journals.eco-vector.com/2310-3825/article/view/626756
- DOI: https://doi.org/10.33848/fopr626756
- ID: 626756
Cite item
Full Text
![Open Access](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_open.png)
![Restricted Access](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_unlock.png)
![Restricted Access](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
Abstract
The primary goal of middle ear cholesteatoma surgery is thoroughly eradicating of the pathology and, as a minimum, preserving hearing at preoperative levels or improving it. In 2017 the European Academy of Otology and Neurotology/Japanese Otological Society (EAONO/JOS) published a new cholesteatoma staging system classification. This prospective study analyzed the surgical outcomes of patients and evaluated the clinical outcomes and factors predicting hearing improvement.
Materials and Methods. A prospective cohort study included 175 patients (178 ears) who undergone MEC surgery from 2016 to 2020. Based on pre-surgical computed tomography of the temporal bone and surgical protocols, disease was staged according to the EAONO/JOS staging system. The results obtained by pre- and postoperative pure tone audiometry were analyzed according to the surgical technique used and according to the stage of the disease. Several potential prognostic factors were evaluated: type of surgical technique, state of the ossicular chain, type of prosthesis and extension of the process.
Results. Statistically significant hearing improvement was revealed after 1 and 3 years in patients with preserved stapes superstructure (p<0.001 and p=0.019, respectively), as well as after 1 year in patients who underwent surgery with intact canal wall (p=0.001). The influence of the process extension (stages according to EAONO/JOS staging system) on the long term functional outcome after 1 and 3 years was revealed (p=0,007 and p=0,005).
Conclusions. Predictors of successful postoperative functional outcomes are: low grade of EAONO/JOS stage, preservation of the stapes superstructure, type of surgery (canal wall up mastoidectomy).
Full Text
![Restricted Access](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
About the authors
Olga Yu. Tarasova
FSBEI FPE «Russian Medical Academy of Continuous Professional Education» MOH Russia
Author for correspondence.
Email: olya.tar@inbox.ru
ORCID iD: 0000-0002-6986-9260
SPIN-code: 7867-8350
Postgraduate student of the Department of Otorhinolaryngology, RMACPE
Russian Federation, 125993, Russia, Moscow, Barrikadnaya str., 2/1, p. 1Sergey Ya. Kosyakov
FSBEI FPE «Russian Medical Academy of Continuous Professional Education» MOH Russia
Email: Serkosykov@yandex.ru
ORCID iD: 0000-0001-7242-2593
SPIN-code: 9349-4250
MD, Professor, Head of the Department of Otorhinolaryngology, RMACPE
Russian Federation, 125993, Russia, Moscow, Barrikadnaya str., 2/1, p. 1References
- Yung M., Tono T., Olszewska E., Yamamoto Y., Sudhoff H. et al. EAONO/JOS joint consensus statements on the definitions, classification and staging of middle ear cholesteatoma. J Int Adv Otol. 2017;13:1-8. doi: 10.5152/iao.2017.3363
- Kuo C-L., Shiao A-S., Yung M., Sakagami M., Sudhoff H. et al. Updates and knowledge gaps in cholesteatoma research. BioMed Res Int. 2015:1-17. doi: 10.1155/2015/854024.
- Otorinolaringologiya: teoriya i praktika: rukovodstvo/ per. s angl. pod red. Karpishchenko S.A.; red.: Skoulz M.A., Ramakrishnan V.R. - Moskva: GEOTAR-Media, 2018. - 704 s. (In Russ.).
- Olmedo Martinez J., Ropero Romero F., Sanchez Gomez S. Cholesteatoma: Influence of surgical technique and EAONO/JOS stage on audiological results. Acta Otorrinolaringol Esp (Engl Ed). 2021:73(3):184-190.
- Fukuda A., Morita S., Nakamaru Y., Hoshino K., Fujiwara K. et al. Short-Term Hearing Prognosis of Ossiculoplasty in Pars Flaccida Cholesteatoma Using the EAONO/JOS Staging System. J Int Adv Otol. 2019;15(1):2-7. doi: 10.5152/iao.2019.5983
- Ardıc F.N., Mengi E., Tümkaya F., Kara C.O., Bir F. Correlation between Surgical Outcome and Stage of Acquired Middle Ear Cholesteatoma: Revalidation of the EAONO/JOS Staging System. J Int Adv Otol. 2020;16(1):34-39. doi: 10.5152/iao.2020.7598
- Castro Sousa A., Henriques V., Rodrigues J., Fonseca R. Ossiculoplasty in chronic otitis media: Surgical results and prognostic factors of surgical success. Acta Otorrinolaringol Esp (Engl Ed). 2017;68(3):131-137. doi: 10.1016/j.otorri.2016.06.006
- van der Toom H., van der Schroeff M.P., Janssen J., Westzaan A.M., Pauw R.J. A Retrospective Analysis and Comparison of the STAM and STAMCO Classification and EAONO/JOS Cholesteatoma Staging System in Predicting Surgical Treatment Outcomes of Middle Ear Cholesteatoma. Otol Neurotol. 2020;41(4):e468-e474.
- doi: 10.1097/MAO.0000000000002549
- Kalman J., Horvath T., Danos K., Tamas L., Polony G. Primary ossiculoplasties provide better hearing results than revisions: a retrospective cohort study. Eur Arch Otorhinolaryngol. 2023;280(7):3177-3185. doi: 10.1007/s00405-023-07835-y
- Akarcay M., Kalcioglu M.T., Tuysuz O., Timurlenk E., Guclu H. Ossicular chain erosion in chronic otitis media patients with cholesteatoma or granulation tissue or without those: analysis of 915 cases. Eur Arch Otorhinolaryngol. 2019;276:1301–1305. doi: 10.1007/s00405-019-05339-2
- Albera R., Canale A., Piumetto E., Lacilla M., Dagna F. Ossicular chain lesions in cholesteatoma. Acta Otorhinolaryngol Ital. 2012;32:309–313.
- Lesinskas E., Stankeviciute V. Results of revision tympanoplasty for chronic non-cholesteatomatous otitis media. Auris Nasus Larynx. 2011;38:196–202. doi: 10.1016/j.anl.2010.07.010
- Horvath T., Lukacs D., Horvath B., Ferenci T., Liktor B. Does the type of ossicular chain lesion affect outcomes in chronic suppurative otitis media without cholesteatoma? J Int Adv Otol. 2019;15:28–33. doi: 10.5152/iao.2019.5554
- Elicora S.S., Erdem D., Dinc A.E., Damar M., Biskin S. The effects of surgery type and different ossiculoplasty materials on the hearing results in cholesteatoma surgery. Eur Arch Otorhinolaryngol. 2017;274:773–780. doi: 10.1007/s00405-016-4350-5
- Martin A.D., Harner S.G. Ossicular reconstruction with titanium prosthesis. Laryngoscope 2004;114:61–64.
- doi: 10.1097/00005537-200401000-00010
- Dornhoffer J.L., Gardner E. Prognostic factors in ossiculoplasty: a statistical staging system. Otol Neurotol. 2001;22:299–304.
- doi: 10.1097/00129492-200105000-00005
- Hajela A., Kumar S., Singh H.P., Verma V. Comparison of ossiculoplasty using autograft ossicle versus allograft (teflon). Indian J Otolaryngol Head Neck Surg. 2019;71:1309–1313. doi: 10.1007/s12070-018-1369-5
- Zhang L.C., Zhang T.Y., Dai P.D., Luo J.F. Titanium versus non-titanium prostheses in ossiculoplasty: a meta-analysis. Acta Otolaryngol. 2011;131:708–715. doi: 10.3109/00016489.2011.556662
- Mardassi A., Deveze A., Sanjuan M., Mancini J., Parikh B. et al. Titanium ossicular chain replacement prostheses: prognostic factors and preliminary functional results. Eur Ann Otorhinolaryngol Head Neck Dis. 2011;128:53–58. doi: 10.1016/j.anorl.2010.11.005
- Quaranta N., Zizzi S., Quaranta A. Hearing results using titanium ossicular replacement prosthesis in intact canal wall tympanoplasty for cholesteatoma. Acta Otolaryngol. 2011;131:36–40. doi: 10.3109/00016489.2010.516014
- De Vos C., Gersdorff M., Gerard J.M. Prognostic factors in ossiculoplasty. Otol Neurotol. 2007;28:61–67. doi: 10.1097/01.mao.0000231598.33585.8f
Supplementary files
![](/img/style/loading.gif)