Nationwide survey of congenital cholesteatoma using staging and classification criteria for middle ear cholesteatoma proposed by the Japan Otological Society.
Nationwide survey of congenital cholesteatoma using staging and classification criteria for middle ear cholesteatoma proposed by the Japan Otological Society.
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DOI：
10.1016/j.anl.2018.10.015
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发表时间：
2019-06
期刊：
影响因子：
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通讯作者：
Y. Morita;T. Tono;M. Sakagami;Yutaka Yamamoto;K. Matsuda;Manabu Komori;N. Hato;S. Hashimoto;Haruo Takahashi;H. Kojima
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文献类型：
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作者：
Y. Morita;T. Tono;M. Sakagami;Yutaka Yamamoto;K. Matsuda;Manabu Komori;N. Hato;S. Hashimoto;Haruo Takahashi;H. Kojima
本研究旨在通过日本耳科学会（JOS）提出的中耳乳突瘤分期和分类标准进行全国性调查，以确定日本先天性中耳乳突瘤（CC）的特征。74个机构共登记1787例，其中CC占中耳乳突瘤病例的12.9%（231例）。根据JOS 2015年提出的中耳炎的分类和分期标准，对中耳炎的病变范围进行分类。结果患者年龄1 ~ 55岁，平均8.2岁，中位年龄6岁，其中男性149耳，女性82耳。在这些病例中，105例（45.5%）被分类为I期，121例（52.4%）被分类为II期，5例（2.1%）被分类为III期，没有IV期病例。在Ⅰ期亚分类中，Ⅰ a期35耳（33%），Ⅰ b期43耳（41%），Ⅰ c期27耳（26%）。I-b期（局限于鼓室后半部的中耳炎）比I-a期（鼓室前半部）更常见。术前气导听力I-a期20.5 dB，I-b期34.5 dB，I-c期30.5 dB，II期38.6 dB，III期59.0 dB。镫骨上部结构缺失率随病情进展而增加。同样，随着疾病的进展，乳突的发育也会降低。手术年龄，术前听力水平，镫骨的状态，主要的听骨成形术，阶段L-A和L-B之间有显着差异。结论CC在日本的当前条件进行了评估，特别是，它被观察到，仅限于鼓室后部的情况并不罕见。基于疾病进展的JOS分期似乎简单有效。
ObjectiveThis study was undertaken to determine the characteristics of congenital cholesteatoma (CC) in Japan, via a nationwide survey using staging and classification criteria for middle ear cholesteatoma, as proposed by the Japan Otological Society (JOS).MethodsA nationwide survey regarding middle ear cholesteatoma treated in 2015 was performed. There were 1787 registrations from 74 facilities, among which, CC accounted for 12.9% (231 cases) of all middle ear cholesteatoma cases. The extent of the disease was classified according to the classification and staging of cholesteatoma proposed by JOS in 2015.ResultsThe age of the patients ranged from 1 to 55 years (mean, 8.2 years; median, 6 years; 149 ears of males; 82 ears of females). Among these cases, 105 (45.5%) were classified as stage I, 121 (52.4%) as stage II, and 5 (2.1%) as stage III, with no cases in stage IV. In the sub classification of stage I, 35 (33%), 43 (41%) and 27 (26%) ears were classified as stages I-a, I-b and I-c, respectively. Stage I-b (cholesteatoma confined to the posterior half of the tympanic cavity) was more frequent than stage I-a (the anterior half of tympanic cavity). Pre-operative hearing level of air-conduction was 20.5 dB for stage I-a, 34.5 dB for stage I-b, 30.5 dB for stage I-c, 38.6 dB for stage II, and 59.0 dB for stage III. The rate of missing stapes superstructure increased as the disease progressed. In the same way, the mastoid development lowered as the stage of the disease progressed. There were significant differences in the age at operation, pre-operative hearing level, status of stapes, and major ossiculoplasty, between stage l-a and l-b.ConclusionsThe current condition of CC in Japan was been evaluated; in particular, it was observed that the cases limited to the posterior part of tympanic cavity were not rare. The JOS stage classification based on the progression of the disease seemed simple and efficient.