10-Year Outcome following Primary Cholesteatoma Surgery at Waikato Hospital 2011-2021
Authors:
Yuan, H.; Emanuel, H.; Department of Otolaryngology, Waikato Hospital, Hamilton, New Zealand
Introduction:
Cholesteatoma is a benign pseudo-cystic lesion of the temporal bone which usually requires surgical extirpation. Long-term outcomes following primary cholesteatoma surgery in Waikato Hospital remain unexplored.
Aim:
To assess recurrence in patients who received their first cholesteatoma surgery at Waikato Hospital over a 10-year period between January 2011 to February 2022.Â
Methodology:
Electronic record of 181 individual ears receiving primary cholesteatoma surgery was reviewed for: demographics, NZ deprivation scale, smoking status, disease location, disease complications, ossicular chain involvement, waiting time, recurrence, surgical approach, surgical complications, follow up and audiologic assessment. The mean, standard deviation, standard error and 95% confidence intervals calculated. Kaplan Meier analysis used for measuring 5-year disease free survival.
Results:
The mean age of diagnosis is 35.21(95% confidence interval/CI 32.0-38.3). 68% of cases received canal wall up mastoidectomy, 22% received canal wall down mastoidectomy. Over 60% of cases had both tympanic and attic involvement, whilst over 30% of cases had disease found in mastoid, anterior epitympanic space or sinus tympani. Ossicles were eroded in 69% of cases. The 5-year recurrence rate is 10%, with an average recurrence time of 3.8 years. 6% of patients were lost to follow up, with an average follow up time of 4 years.
Conclusions:
The recurrence rate at our institution is comparable to the 5-year recurrence rate of 15-39% reported in the literature (1). The proportion of patients lost to follow up likely impacts the overall recurrence rate.
References:
Mller PR, Pedersen CN, Grosfjeld LR, Faber CE, Djurhuus BD. Recurrence of Cholesteatoma - A Retrospective Study Including 1,006 Patients for More than 33 Years. Int Arch Otorhinolaryngol. 2020 Jan;24(1): e18-e23. doi: 10.1055/s-0039-1697989. Epub 2019 Dec 20. PMID: 31915464; PMCID: PMC6946954
Yuan, H.; Emanuel, H.; Department of Otolaryngology, Waikato Hospital, Hamilton, New Zealand
Introduction:
Cholesteatoma is a benign pseudo-cystic lesion of the temporal bone which usually requires surgical extirpation. Long-term outcomes following primary cholesteatoma surgery in Waikato Hospital remain unexplored.
Aim:
To assess recurrence in patients who received their first cholesteatoma surgery at Waikato Hospital over a 10-year period between January 2011 to February 2022.Â
Methodology:
Electronic record of 181 individual ears receiving primary cholesteatoma surgery was reviewed for: demographics, NZ deprivation scale, smoking status, disease location, disease complications, ossicular chain involvement, waiting time, recurrence, surgical approach, surgical complications, follow up and audiologic assessment. The mean, standard deviation, standard error and 95% confidence intervals calculated. Kaplan Meier analysis used for measuring 5-year disease free survival.
Results:
The mean age of diagnosis is 35.21(95% confidence interval/CI 32.0-38.3). 68% of cases received canal wall up mastoidectomy, 22% received canal wall down mastoidectomy. Over 60% of cases had both tympanic and attic involvement, whilst over 30% of cases had disease found in mastoid, anterior epitympanic space or sinus tympani. Ossicles were eroded in 69% of cases. The 5-year recurrence rate is 10%, with an average recurrence time of 3.8 years. 6% of patients were lost to follow up, with an average follow up time of 4 years.
Conclusions:
The recurrence rate at our institution is comparable to the 5-year recurrence rate of 15-39% reported in the literature (1). The proportion of patients lost to follow up likely impacts the overall recurrence rate.
References:
Mller PR, Pedersen CN, Grosfjeld LR, Faber CE, Djurhuus BD. Recurrence of Cholesteatoma - A Retrospective Study Including 1,006 Patients for More than 33 Years. Int Arch Otorhinolaryngol. 2020 Jan;24(1): e18-e23. doi: 10.1055/s-0039-1697989. Epub 2019 Dec 20. PMID: 31915464; PMCID: PMC6946954
