Postoperative Results of Congenital Middle Ear Cholesteatoma According to Location, Type and Stage

Chang, Sun O; Kim, Dae Woo; Moon, Il Joon; Choi, Byung Yoon; Lee, Hyo Jeong; Oh, Seung Ha; Kwon, Seong Keun; Lee, Myung Chul; Kim, Chong Sun

Abstract

BACKGROUND AND OBJECTIVES
Although there are various classification and staging systems of congenital middle ear cholesteatoma to predict the prognosis, the definite prognostic factors have not been elucidated yet. Aims of this study were to analyze the postoperative hearing results and recidivism of congenital middle ear cholesteatoma according to stage, location and type. MATERIALS AND METHOD: Thirty-eight cases of congenital middle ear cholesteatoma that had been treated from January 1989 through February 2003 were reviewed retrospectively. Tympanization cases without ossiculoplasty were excluded in the analysis of hearing results. RESULTS: The closed type and the anterior disease showed better hearing results and less residual disease than did the open type and the posterior disease. Cholesteatomas of lower stages (stage I, II) presented better hearing results than the higher stage. Stage IV was strongly associated with recidivism. While the lower stage was related to anterior disease and the closed type, the higher stage was linked with the posterior disease and the open type. To assess the staging system, a further study using a large population will be needed. CONCLUSION: The location, type and stage may be useful in predicting hearing results and recidivism. In the higher stages, careful eradication of disease and planned second look operation are recommended.