In:
Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. 6 ( 2022-7), p. 657-665
Abstract:
Cholesteatoma is occasionally accompanied by excessive calcification and presumably has different osteogenic dynamics compared to noncholesteatomous chronic otitis media. Cholesteatoma-related sclerotic lesions through the temporal bone can pose manipulatory difficulties, possibly leading to worse surgical outcomes or complications. Therefore, we compared surgical outcomes of cholesteatomas with and without sclerotic lesions. Study design Retrospective cohort study. Setting Tertiary academic medical center. Patients Consecutive ears with acquired cholesteatomas requiring primary resection between January 2009 and December 2019. The ears followed up for 〈 1 year were excluded. Interventions Tympanoplasty with/without mastoidectomy. Main Outcome Measures Prevalence and location of sclerotic lesion, comorbid fistulae, postoperative air-bone gap, recidivism, and complications. Results Overall, 19 (6.4%) of 299 ears had sclerotic lesions. More than two-thirds (68.4%) of sclerotic lesions were located adjacent to the lateral semicircular canal (LSC). Among ears with sclerotic lesions adjacent to the LSC, 46.2% had a comorbid fistula in the LSC. The prevalence of labyrinth fistula was significantly greater in ears with sclerotic lesions (42.1%) than in ears without sclerotic lesions (5.0%) ( p 〈 0.0001, Fisher’s exact test). Sensorineural hearing deterioration was significantly higher in ears with sclerotic lesions than in ears without ( p = 0.0004, Fisher’s exact test). Multivariate logistic regression analysis demonstrated that the presence of sclerotic lesions was a significant prognostic factor for residual disease (odds ratio [95% confidence interval]: 6.820 [2.055–22.633] , p = 0.0017). Conclusions Surgeons should be conscious of preoperative identification of sclerotic lesions adjacent to one of the semicircular canals, possibly leading to postoperative sensorineural hearing deterioration or residual cholesteatoma.
Type of Medium:
Online Resource
ISSN:
1531-7129
,
1537-4505
DOI:
10.1097/MAO.0000000000003564
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2036790-9
detail.hit.zdb_id:
2058738-7
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