Evaluation of Long-term Cholesteatoma Recidivism: Using the JOS, EAONO-JOS, and STAMCO Cholesteatoma Staging Systems.
Otol Neurotol
; 42(7): 1031-1038, 2021 08 01.
Article
em En
| MEDLINE
| ID: mdl-34260507
ABSTRACT
OBJECTIVE:
To assess the prognostic value of the Japanese Otological Society (JOS), EAONO-JOS, and STAMCO classifications in predicting the severity of acquired cholesteatoma and to identify other factors that could influence residual and recurrent cholesteatoma, as well as adverse events (AE).METHOD:
A retrospective chart review of patients undergoing primary cholesteatoma surgery in our tertiary referral center. Primary outcome measures were based on three groups of follow-up (FU) Group A, studying residual cholesteatoma, FUâ>â52âweeks of last-look surgery or magnetic resonance imaging, diffusion-weighted imaging; group B, studying recurrent disease, FUâ>â52âweeks of last outpatient clinic visit; and group C, studying AE, FUâ>â12âweeks after surgery. Cholesteatomata were staged according to the JOS, EAONO-JOS, and STAMCO classifications. Kaplan-Meier curves were used to determine the prognostic value of the various classifications and to identify other determining factors, while correcting for FU.RESULTS:
FU was found to be a significant confounder. No correlation was found between staging and the occurrence of residual or recurrent disease, nor the occurrence of AE. Type of surgery was a significant determinant of all three primary outcome measures. A higher age was associated with a lower risk of residual disease.CONCLUSION:
In our population the JOS, EAONO-JOS, and STAMCO classifications have limited prognostic value. Three main confounders were identified that pose a challenge in developing a universal classification FU, surgery type, and age. Cholesteatoma staging should be postponed until a system is developed which significantly correlates cholesteatoma stage to cholesteatoma severity, to have implications for management strategies.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Colesteatoma da Orelha Média
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Reincidência
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article