Comparison of surgical treatment and outcomes between pars flaccida cholesteatoma and pars tensa cholesteatoma based on the staging criteria for cholesteatoma 2010 Japan

DOI
  • Morita Yuka
    Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Niigata University
  • Yamamoto Yutaka
    Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Niigata University
  • Oshima Shinsuke
    Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Niigata University
  • Takahashi Kuniyuki
    Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Niigata University
  • Nemoto Mika
    Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Niigata University
  • Kuwabara Yuko
    Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Niigata University
  • Takahashi Sugata
    Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Niigata University

Bibliographic Information

Other Title
  • 弛緩部型真珠腫と緊張部型真珠腫 (第2報)
  • -当科における術式選択と治療成績-

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Description

Patients with pars flaccida cholesteatoma and pars tensa cholesteatoma who underwent initial surgery in our institute were classified based on the Classification and Staging of Cholesteatoma proposed by the Japan Otological Society in 2010. And we investigated the choice of surgical treatment and its outcome.<br>Between 1999 and 2009, 238 cases of pars flaccida and 60 cases of pars tensa cholesteatoma were underwent surgery in Niigata University. Average age at the surgery was 43.5 years in flaccida type and 50 years in tensa type respectively.<br>Regarding the surgical procedure, canal wall down tympanoplasty with mastoid obliteration was selected in 70% cases both pars flaccida type and pars tensa type. Considering the stage, trans canal atticotomy and canal wall up tympanoplasy were selected more frequently in the case of Stage I. And open method was adopted for 30% cases of Stage III in pars flaccida type.<br>Hearing improvement in all subjects with pars flaccida cholesteatoma was 77.0% and that with pars tensa 44.2%. By the stage, success rate in the stage I was 84.6%, stage II 78.6% and stage III 60.9% in the pars flaccida cases. In pars tensa cholesteatoma, 85.7%, 41.4% and 31.3% respectively. In the pars flaccida cases, the tendency of deterioration of hearing result according to the extent of cholesteatoma was observed. But some cases of pars tensa cholesteatoma could not be obtained hearing improvement regardless the stage, the affected area and the status of stapes. The rate of recurrence was 6.2% in pars flassida and in 5.8% in pars tensa. As a conclusion, the control of cholesteatoma in the reported sases was satisfactory, but challenges remained to improve hearing.

Journal

  • Otology Japan

    Otology Japan 24 (3), 181-187, 2014

    Japan Otological Society

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