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Radiological and audiological prediction for hearing outcome in cholesteatoma recidivism surgery

  • Otology
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Abstract

Purpose

In cholesteatoma recidivism, achieving satisfactory hearing outcome after revision surgery remains challenging. The presence of concomitant recidivism pathology or related anatomical abnormalities can impact revision reconstruction of the sound transmission system. The current study aimed to identify prognostic factors affecting hearing outcomes after surgery for cholesteatoma recidivism.

Methods

This retrospective cohort study included consecutive patients whose ears required initial surgery for recidivism between January 2016 and December 2021. Patients followed up for < 6 months and those not indicated for ossiculoplasty were excluded. The impact of preoperative otoscopic findings, computed tomography (CT) features, and hearing levels on the prediction of satisfactory hearing (postoperative air–bone gap [ABG] ≤ 20 dB) was evaluated using univariate and multivariate logistic regression analyses.

Results

Overall, 102 patients were included, with a mean follow-up of 24.8 months. Multivariate logistic regression analysis revealed the following independent predictive factors for satisfactory hearing: presence of aeration in the tympanic cavity (odds ratio [OR] [95% confidence interval {CI}]: 13.287 [1.113–158.604], p = 0.0409), absence of soft-tissue density occupying the oval window (OR [95% CI]: 13.445 [3.178–56.887], p = 0.0040), and ≤ 22.5 dB preoperative ABG in four-frequency average (OR [95% CI]: 9.339 [2.026–43.050], p = 0.0042).

Conclusions

For cholesteatoma recidivism, reliable preoperative prediction based on CT and ABG would facilitate decision-making regarding the probability of efficient revision ossiculoplasty or appropriate preoperative counseling, including early hearing rehabilitation using hearing aids or implementation of simultaneous implantable hearing equipment during surgery for recidivism.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available owing to privacy or ethical restrictions.

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Acknowledgements

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan

    Masaomi Motegi, Yutaka Yamamoto, Takara Nakazawa, Takeshi Tada, Motoki Hirabayashi, Sho Kurihara, Masahiro Takahashi, Sayaka Sampei, Kazuhisa Yamamoto, Yuika Sakurai & Hiromi Kojima

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  1. Masaomi Motegi
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  2. Yutaka Yamamoto
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  3. Takara Nakazawa
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Contributions

Concept: MM; design: MM, YY; supervision: HK; resource: TN, SK, MT, SS, KY; materials: TT, MH; data collection and/or processing: MM; analysis and/or interpretation: MM; literature search: MM; writing: MM: critical reviews: YY.

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Correspondence to Masaomi Motegi.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose. The authors alone are responsible for the content and writing of the manuscript.

Ethical approval

Approval was obtained from the institutional review board of The Jikei University School of Medicine (approval number: 32-205[10286]). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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The requirement for informed consent was waived owing to the retrospective nature of the study.

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Motegi, M., Yamamoto, Y., Nakazawa, T. et al. Radiological and audiological prediction for hearing outcome in cholesteatoma recidivism surgery. Eur Arch Otorhinolaryngol 280, 2715–2724 (2023). https://doi.org/10.1007/s00405-022-07760-6

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