Nationwide survey of middle ear cholesteatoma surgery cases in Japan: Results from the Japan Otological society registry using the JOS staging and classification system
Nationwide survey of middle ear cholesteatoma surgery cases in Japan: Results from the Japan Otological society registry using the JOS staging and classification system
复制标题
日本中耳胆脂瘤手术病例全国调查：日本耳科学会登记处使用 JOS 分期和分类系统的结果
DOI：
10.1016/j.anl.2020.09.011
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发表时间：
2021
影响因子：
1.7
通讯作者：
Takahashi Haruo
中科院分区：
文献类型：
--
作者：
Komori Manabu;Morita Yuka;Tono Tetsuya;Matsuda Keiji;Yamamoto Yutaka;Sakagami Masafumi;Hato Naohito;Kojima Hiromi;Takahashi Haruo
本研究的目的是确定中耳乳突瘤的特点，并调查短期结果的残留率和复发率乳突瘤和术后听力结果在日本，通过全国范围内的调查，使用分期和分类标准中耳乳突瘤，由日本耳科学会（JOS）提出的。目标是2015年1月至12月期间在日本接受手术治疗的中耳乳突瘤患者。患者的医疗信息是匿名的。调查问卷的条目包括年龄、性别、中耳炎的分类和分期、术前听力水平、乳突发育、镫骨状态和手术方法。共有来自日本各地74家机构的1，787名登记患者。第二次调查于2018年1月进行，收到了来自日本49家工厂的1，456份回复。结果最常见的中耳炎类型为松弛部中耳炎（63.3%），其次为张力部中耳炎（13.0%），先天性中耳炎（12.9%），慢性张力穿孔继发性中耳炎（5.6%）。来源不明的胆脂瘤占5.0%（90例）。II期主要见于松弛部和张力部的中耳乳突瘤，常累及乳突，而约一半继发于慢性张力穿孔的中耳乳突瘤和先天性中耳乳突瘤被归类为I期。1,084例患者中有152例（14.0%）在首次手术后出现复发性中耳瘤、残留性中耳瘤或两者兼而有之。术后听力恢复成功率为63.3%。结论本研究不仅明确了日本中耳乳突瘤的流行病学现状，而且也了解了日本中耳乳突瘤手术的发展趋势。由JOS委员会开发一个分期系统，为流行病学数据库服务，以进行国际或随时间变化的比较。可以合理可靠地使用这种分级系统。
ObjectiveThis study was aimed to determine the characteristics of middle ear cholesteatoma and to investigate short-term outcomes regarding the rates of residual and recurrent cholesteatoma and the postoperative hearing results in Japan, via a nationwide survey using staging and classification criteria for middle ear cholesteatoma, as proposed by the Japan Otological Society (JOS).MethodsThe first-round survey was conducted in 2016. The target was patients with middle ear cholesteatoma who were surgically treated in Japan between January and December 2015. Medical information on the patients was anonymized. The questionnaire entries were age, sex, cholesteatoma classification and stage, preoperative hearing level, mastoid development, status of the stapes, and surgical method. There were a total of 1,787 registered patients from 74 facilities from all over Japan. The second survey was conducted in January 2018 and received 1,456 responses from 49 facilities in Japan. Of the 1,456 cases, 1,060 were conducted in the postoperative hearing survey and 1,084 in the residual recurrence survey.ResultsThe most common cholesteatoma type was pars flaccida cholesteatoma (63.3%), followed by pars tensa cholesteatoma (13.0%), congenital cholesteatoma (12.9%), and cholesteatoma secondary to chronic tensa perforation (5.6%). Cholesteatoma of uncertain origin accounted for 5.0% (90 cases). Stage II was predominant in pars flaccida and pars tensa cholesteatoma, which frequently involves the mastoid, whereas about half of cases of cholesteatoma secondary to chronic tensa perforation and congenital cholesteatoma were classified as stage I. One hundred fifty-two of 1,084 cases (14.0%) had recurrent cholesteatoma, residual cholesteatoma, or both following first surgeries. The postoperative rates of hearing success rate was 63.3%.ConclusionWe were able to clarify not only the current epidemiological status of middle ear cholesteatoma but also the current trends of cholesteatoma surgery in Japan. The development of a staging system by the JOS Committee serving an epidemiological database for international or time-dependent comparison. It is possible to use this staging system with reasonable reliability.