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

Renner B, de Vasconcelos Craveiro A, Balk M, Allner M, Sievert M, Mueller SK, Mantsopoulos K, Iro H, Rupp R, Hornung J, Gostian AO (2023)

Publication Type: Journal article

Publication year: 2023

Journal

European Archives of Oto-Rhino-Laryngology Springer

DOI: 10.1007/s00405-023-07996-w

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.

Authors with CRIS profile

Beatrix Renner Medizinische Fakultät Antonio de Vasconcelos Craveiro Department of Otorhinolaryngology – Head and Neck Surgery Matthias Balk Department of Otorhinolaryngology – Head and Neck Surgery Moritz Allner Department of Otorhinolaryngology – Head and Neck Surgery Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Robin Rupp Department of Otorhinolaryngology – Head and Neck Surgery Joachim Hornung Department of Otorhinolaryngology – Head and Neck Surgery Antoniu-Oreste Gostian Department of Otorhinolaryngology – Head and Neck Surgery

How to cite

APA:

Renner, B., de Vasconcelos Craveiro, A., Balk, M., Allner, M., Sievert, M., Mueller, S.K.,... Gostian, A.-O. (2023). EAONO/JOS classification for acquired cholesteatoma: evaluating the impact of the number of affected sites on treatment and outcomes. European Archives of Oto-Rhino-Laryngology. https://doi.org/10.1007/s00405-023-07996-w

MLA:

Renner, Beatrix, et al. "EAONO/JOS classification for acquired cholesteatoma: evaluating the impact of the number of affected sites on treatment and outcomes." European Archives of Oto-Rhino-Laryngology (2023).

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