Predictors of hearing improvement in patients with middle ear cholesteatoma


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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).

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Olga Tarasova

FSBEI FPE «Russian Medical Academy of Continuous Professional Education» MOH Russia

编辑信件的主要联系方式.
Email: olya.tar@inbox.ru
ORCID iD: 0000-0002-6986-9260
SPIN 代码: 7867-8350

Postgraduate student of the Department of Otorhinolaryngology, RMACPE

俄罗斯联邦, 125993, Russia, Moscow, Barrikadnaya str., 2/1, p. 1

Sergey Kosyakov

FSBEI FPE «Russian Medical Academy of Continuous Professional Education» MOH Russia

Email: Serkosykov@yandex.ru
ORCID iD: 0000-0001-7242-2593
SPIN 代码: 9349-4250

MD, Professor, Head of the Department of Otorhinolaryngology, RMACPE

俄罗斯联邦, 125993, Russia, Moscow, Barrikadnaya str., 2/1, p. 1

参考

  1. 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
  2. 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.
  3. 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.).
  4. 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.
  5. 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
  6. 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
  7. 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
  8. 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.
  9. doi: 10.1097/MAO.0000000000002549
  10. 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
  11. 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
  12. Albera R., Canale A., Piumetto E., Lacilla M., Dagna F. Ossicular chain lesions in cholesteatoma. Acta Otorhinolaryngol Ital. 2012;32:309–313.
  13. 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
  14. 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
  15. 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
  16. Martin A.D., Harner S.G. Ossicular reconstruction with titanium prosthesis. Laryngoscope 2004;114:61–64.
  17. doi: 10.1097/00005537-200401000-00010
  18. Dornhoffer J.L., Gardner E. Prognostic factors in ossiculoplasty: a statistical staging system. Otol Neurotol. 2001;22:299–304.
  19. doi: 10.1097/00129492-200105000-00005
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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

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