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European Archives of Oto-Rhino-Laryngology

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Open Access 23-05-2023 | Cholesteatoma | Otology

EAONO/JOS classification for acquired cholesteatoma: evaluating the impact of the number of affected sites on treatment and outcomes

Authors: B. Renner, A. Vasconcelos Craveiro, M. Balk, M. Allner, M. Sievert, S. K. Mueller, K. Mantsopoulos, H. Iro, R. Rupp, J. Hornung, A. O. Gostian

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2023

Abstract

Purpose

The European and Japanese system for cholesteatoma classification proposed an anatomical differentiation in five sites. In stage I disease, one site would be affected and in stage II, two to five. We tested the significance of this differentiation by analyzing the influence of the number of affected sites on residual disease, hearing ability and surgical complexity.

Methods

Cases of acquired cholesteatoma treated at a single tertiary referral center between 2010-01-01 and 2019-07-31 were retrospectively analyzed. Residual disease was determined according to the system. The air–bone gap mean of 0.5, 1, 2, 3 kHz (ABG) and its change with surgery served as hearing outcome. The surgical complexity was estimated regarding the Wullstein’s tympanoplasty classification and the procedure approach (transcanal, canal up/down).

Results

513 ears (431 patients) were followed-up during 21.6 ± 21.5 months. 107 (20.9%) ears had one site affected, 130 (25.3%) two, 157 (30.6%) three, 72 (14.0%) four and 47 (9.2%) five. An increasing number of affected sites resulted in higher residual rates (9.4–21.3%, p = 0.008) and surgical complexity, as well poorer ABG (preoperative 14.1 to 25.3 dB, postoperative 11.3–16.8 dB, p < 0.001). These differences existed between the means of cases of stage I and II, but also when only considering ears with stage II classification.

Conclusion

The data showed statistically significant differences when comparing the averages of ears with two to five affected sites, questioning the pertinence of the differentiation between stages I and II.

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Title: EAONO/JOS classification for acquired cholesteatoma: evaluating the impact of the number of affected sites on treatment and outcomes
Authors: B. Renner
A. Vasconcelos Craveiro
M. Balk
M. Allner
M. Sievert
S. K. Mueller
K. Mantsopoulos
H. Iro
R. Rupp
J. Hornung
A. O. Gostian
Publication date: 23-05-2023
Publisher: Springer Berlin Heidelberg
Keywords: Cholesteatoma
Tympanoplasty
Published in: European Archives of Oto-Rhino-Laryngology / Issue 11/2023
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-023-07996-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

EAONO/JOS classification for acquired cholesteatoma: evaluating the impact of the number of affected sites on treatment and outcomes

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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