Clinical features of congenital cholesteatoma over 10 years:

DOI 33 References
  • Hidaka Hiroshi
    Department of Otolaryngology Head and Neck Surgery, Tohoku University Graduate School of Medicine
  • Takata Yusuke
    Department of Otolaryngology Head and Neck Surgery, Tohoku University Graduate School of Medicine
  • Miyazaki Hiromitsu
    Department of Otolaryngology Head and Neck Surgery, Tohoku University Graduate School of Medicine
  • Kobayashi Toshimitsu
    Department of Otolaryngology Head and Neck Surgery, Tohoku University Graduate School of Medicine

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Other Title
  • Stage分類にもとづく先天性真珠腫31症例の動向
  • application of a staging system and comparison with the previous decade
  • ─当科における先行報告40耳との比較を含めて─

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Description

Recently, a staging system for congenital cholesteatoma (CC) developed by Potsic has been applied in several studies. To address the validity of that staging system, we retrospectively reviewed the clinical features and outcomes of 31 patients with CC over the decade from 2001 to 2011, comparing findings with those for a previous decade. The stage of CC was determined using Potsic's staging system, with classification into four stages according to ossicular involvement and mastoid extension. Most of the 7 patients categorized as stage I or II were under 5 years old, and diagnosed incidentally. Conversely, 24 cases of stage III or IV showed a higher prevalence of age >5 years, and complained of otitis media and/or hearing loss. Only 2 of these 24 cases had been diagnosed incidentally.<BR>Regarding the location and morphology of diseases, all stage I or II cases were closed-type masses in the anterosuperior quadrant (ASQ). Conversely, only 8% (2/24) of the stage III or IV cases occupied the ASQ without extending to the posterosuperior quadrant (PSQ), with these 2 patients undergoing surgical removal of ossicles to eradicate the disease extending into the Eustachian tube. Half of the stage III or IV cases showed a predilection not for the ASQ, but rather for the PSQ, and 42% of cases (10/24) involved both ASQ and PSQ. Congenital anomalies of the ossicular chain were observed in three stage III cases. <BR>Consistent with outcomes from a previous decade (from 1986 to 1995) reported by Suetake, stage III was the most dominant group, comprising more than 60% in the present study. Although the prevalence of ASQ-type CC has increased slightly, the prevalence of PSQ type categorized into stage III still exceeds that of the ASQ type reported to be the most dominant in Western countries. Different pathogeneses of CC may exist in Asia and Western countries.

Journal

  • Otology Japan

    Otology Japan 22 (5), 870-877, 2012

    Japan Otological Society

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