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European Archives of Oto-Rhino-Laryngology

Open Access 13-02-2024 | Cholesteatoma | Otology

Predicting residual cholesteatoma with the Potsic staging system still lacks evidence: a systematic review and meta-analysis

Authors: Klára Borbála Körmendy, Kinga Shenker-Horváth, Alexander Shulze Wenning, Péter Fehérvári, Andrea Harnos, Péter Hegyi, Zsolt Molnár, Kata Illés, Tamás Horváth

Published in: European Archives of Oto-Rhino-Laryngology

Abstract

Purpose

To investigate the rate of residual disease in the Potsic staging system for congenital cholesteatomas.

Methods

A protocol registration was published on PROSPERO (CRD42022383932), describing residual disease as a primary outcome and hearing improvement as secondary. A systematic search was performed in four databases (PubMed, Embase, Cochrane Library, Web of Science) on December 14, 2022. Articles were included if cholesteatomas were staged according to the Potsic system and follow-up duration was documented. Risk of bias was evaluated using the Quality In Prognosis Studies (QUIPS) tool. In the statistical synthesis a random effects model was used. Between-study heterogeneity was assessed using I².

Results

Thirteen articles were found to be eligible for systematic review and seven were included in the meta-analysis section. All records were retrospective cohort studies with high risk of bias. Regarding the proportions of residual disease, analysis using the χ² test showed no statistically significant difference between Potsic stages after a follow-up of minimum one year (stage I 0.06 (confidence interval (CI) 0.01–0.33); stage II 0.20 (CI 0.09–0.38); stage III 0.06 (CI 0.00–0.61); stage IV: 0.17 (CI 0.01–0.81)). Postoperative and preoperative hearing outcomes could not be analyzed due to varied reporting. Results on cholesteatoma location and mean age at staging were consistent with those previously published.

Conclusion

No statistically significant difference was found in the proportions of residual disease between Potsic stages, thus the staging system’s applicability for outcome prediction could not be proven based on the available data. Targeted studies are needed for a higher level of evidence.

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Title: Predicting residual cholesteatoma with the Potsic staging system still lacks evidence: a systematic review and meta-analysis
Authors: Klára Borbála Körmendy
Kinga Shenker-Horváth
Alexander Shulze Wenning
Péter Fehérvári
Andrea Harnos
Péter Hegyi
Zsolt Molnár
Kata Illés
Tamás Horváth
Publication date: 13-02-2024
Publisher: Springer Berlin Heidelberg
Keyword: Cholesteatoma
Published in: European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08478-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predicting residual cholesteatoma with the Potsic staging system still lacks evidence: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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