Kubota, Toshinori1; Ito, Tsukasa1; Furukawa, Takatoshi1; Matsui, Hirooki1; Goto, Takanari1; Futai, Kazunori1; Watanabe, Chihiro1; Kakehata, Seiji1
1 Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.
We examined the surgical treatment methods for congenital cholesteatomas (CC).
Study Design: A prospective case series.
Setting: University hospital.
Patients: Twenty-five patients with CCs who underwent surgery from December 2011 to December 2017 (mean age/range: 7 yr/2–16 yr; 16 male/9 female; mean follow-up/range 3.4 yr/0.6–6.7 yr).
Interventions: Patients underwent either transcanal ear endoscopic surgery (TEES) or non-TEES.
Main Outcome Measures: We examined the surgical approach rate (TEES vs. non-TEES), residual rate and factors related to residual rate (Potsic staging system grade; stages (one-stage or two-stage operations); and CC types (open or closed)). These residual rate factors were analyzed by logistic regression analysis.
Results: Twenty patients (80%) were treated with TEES and 5 patients were treated with non-TEES. The 19 patients with a Potsic grade of III or lower underwent TEES. Six patients (24%) had residual cholesteatomas. The residual rate was significantly influenced by the type of CC (odds ratio: 51.796, 95% confidence interval: 1.7065-1572.1, p=0.0234) with all 6 patients classified as open-type CC and 5 out of the 6 patients underwent a one-stage operation.
The results of this study strongly suggest that the residual rate for CCs could be decreased by performing a two-stage operation for all open-type CCs.