Practical analysis of pars flaccida cholesteatoma with classification and staging system proposed by Japan Otological Society: a comparative study

Abstract

Background: The Japan Otology Society (JOS) proposed the classification and staging system for middle ear cholesteatoma. However, there was little analysis of the pathology of cholesteatoma using this staging system.

Aims/objectives: To analyze the pathology of pars flaccida cholesteatoma using the staging system by JOS.

Material and methods: A total of 183 cases of fresh pars flaccida cholesteatoma treated between January 2009 and December 2015 were included. We used the staging system recommended by JOS (2015). The association of the following variables in each stage of pars flaccida cholesteatoma was examined: age, gender, preoperative hearing level, staging, statuses of mastoid cell growth and stapes, tympanic sinus invasion.

Results: Stage II disease showed the highest degree of progression, and peak incidence was observed in the third and fourth decades of life. Stage III significantly increased after the age of 40 years. The progression of the disease stage was significantly associated with deterioration of hearing level. Cholesteatoma invasion to tympanic sinus was recognized in 14.2% of cases. The state of the stapes is increasingly likely be to fracture as stage progresses.

Conclusions: The JOS Staging System appropriately reflects the disease state, and it was found to be clinically meaningful in this study.

Chinese abstract

背景：日本耳科学会（JOS）提出了中耳胆脂瘤的分类和分期系统。然而, 很少有使用该分期系统对胆脂瘤进行的病理学分析。

目的：使用JOS的分期系统分析松弛部胆脂瘤的病理。

材料和方法：包括2009年1月至2015年12月期间治疗的183例新松弛部胆脂瘤患者。我们使用了JOS（2015）推荐的分期系统。检查了在松弛部胆脂瘤的每个阶段中下列变量之间的关系：年龄、性别、术前听力水平、所处阶段、乳突细胞生长和镫骨的状态、鼓室窦侵蚀。

结果：II期疾病表现出最高的发展程度, 并且在三十多岁和四十多岁这个年龄段中观察到高峰发病率。III期疾病在40岁后显着增加。疾病阶段的发展与听力水平的下降显著相关。 14.2％的患者中发现胆脂瘤侵蚀鼓室窦。镫骨的状态随着阶段的进展越来越可能破裂。

结论：JOS分期系统适当地反映了疾病状态。本研究发现它具有临床意义。

Keywords:

• Middle ear cholesteatoma
• acquired cholesteatoma
• pathogenesis

Disclosure statement

No potential conflict of interest was reported by the authors.