Cholesteatoma in chronic otitis media secondary to pars tensa perforation

Abstract

Background

Acquired cholesteatoma secondary to pars tensa perforation was rare in clinic.

Objectives

In this study, we explored factors related to acquired cholesteatoma in chronic otitis media patients with pars tensa perforation.

Material and Methods

262 adults (296 ears) with pars tensa perforation were divided into four groups: anterior perforation group, posterior perforation group, central perforation group, and marginal perforation group. Analysis was carried out in terms of cholesteatoma formation, adhesion of perforation edges, mastoid pneumatization, and the function of eustachian tube.

Results

Cholesteatoma was found in 34% (18 in 53 ears) in posterior perforation group, 14.3% (14 in 98 ears) in marginal perforation group, and 2.5% (2 in 80 ears) in anterior perforation group. For subjects with adhesion in perforation edges, cholesteatoma was approved in 94% of posterior perforation, 42% of marginal perforation and 25% of anterior perforation groups. The adhesion in perforation edges and function of eustachian tube instead of mastoid pneumatization were statistically significant for cholesteatoma formation.

Conclusions and Significance

Acquired cholesteatoma was mostly found in patients with posterior and marginal perforation, followed by anterior perforation. Adhesion of perforation edges was another risk factor for cholesteatoma formation. Eustachian tube also functioned by influencing the ventilation of middle ear.

Chinese Abstract

背景：继发于耳膜后下部穿孔的获得性胆脂瘤在临床上很少见。

目的：在本研究中, 我们探讨了耳膜后下部穿孔的慢性中耳炎患者的获得性胆脂瘤的相关因素。

材料与方法：将 262 名（296 只耳朵）患有耳膜后下部穿孔的成人分为四组：前穿孔组、后穿孔组、中央穿孔组和边缘穿孔组。 针对胆脂瘤形成、穿孔边缘粘连、乳突气化和咽鼓管功能进行了分析。

结果：后穿孔组胆脂瘤发生率为34%（53只耳中的18只）, 边缘穿孔组为14.3%（98 只耳中有 14 只）, 前穿孔组为 2.5%（80 只耳中有 2 只）。 对于穿孔边缘粘连的患者, 94% 的后穿孔组, 42%的边缘穿孔组和25%的前穿孔组证实有胆脂瘤。 穿孔边缘粘连与咽鼓管而不是乳突气化的功能对于胆脂瘤的形成具有统计学意义。

结论与意义：获得性胆脂瘤最多见于后穿孔和边缘穿孔的患者, 然后才是前穿孔患者。 穿孔边缘粘附是胆脂瘤形成的另一个危险因素。 咽鼓管也通过影响中耳通气来发挥作用。

Keywords:

• Cholesteatoma
• pars tensa perforation
• adhesion
• inflammation

Acknowledgements

The authors thank all the patients recruited in this study. We appreciate their understanding and supporting during the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).