Matsuda Keiji, Tono Tetsuya, Kojima Hiromi, Yamamoto Yutaka, Sakagami Masafumi, Mishiro Yasuo, Hinohira Yasuyuki, Okuno Taeko
Department of Otorhinolaryngology - Head & Neck Surgery, University of Miyazaki, Japan.
Department of Otorhinolaryngology, Jikei University School of Medicine, Japan.
Auris Nasus Larynx. 2018 Feb;45(1):45-50. doi: 10.1016/j.anl.2017.02.005. Epub 2017 Mar 6.
The Objective of this study was to assess the practicality of the cholesteatoma staging system proposed by the Japan Otological Society (JOS) for acquired middle ear cholesteatoma (the 2010 JOS staging system).
Between 2009 and 2010, 446 ears with retraction pocket cholesteatoma underwent primary surgery at 6 institutions in Japan. The extent of cholesteatoma was surgically confirmed, and classified into three stages.
The cholesteatoma affected the pars flaccida in 325 ears (73%), the pars tensa in 100 ears (22%), and both regions combined in 21 ears (5%). The hearing outcome (postoperative air-bone gaps dB) worsened as follows (Stage I, II, III): 84%, 68%, 53% in pars flaccida; 71%, 62%, 30% in pars tensa, and 42% at Stage II, and 50% at Stage III in the combined group. The incidence of residual cholesteatoma increased as follows (Stage I, II, III): 2%, 12%, 23% in pars flaccida; 7%, 30%, 21% in the pars tensa group. The severity of disease was reflected in postoperative hearing and increasing incidence of recurrence rate.
The 2010 JOS staging system is suitable for evaluating initial pathology. It is particularly practical for standardizing reporting of retraction pocket cholesteatoma and for adjusting for the severity of the condition during outcome evaluations. It may also provide information that is useful for counseling patients.
本研究旨在评估日本耳科学会（JOS）提出的后天性中耳胆脂瘤分期系统（2010年JOS分期系统）的实用性。
2009年至2010年间，日本6家机构对446例内陷袋型胆脂瘤患者的耳朵进行了初次手术。通过手术确认胆脂瘤的范围，并将其分为三个阶段。
胆脂瘤累及松弛部的有325耳（73%），紧张部的有100耳（22%），两者均累及的有21耳（5%）。听力结果（术后气骨导差dB）恶化情况如下（I期、II期、III期）：松弛部为84%、68%、53%；紧张部为71%、62%、30%，联合组II期为42%，III期为50%。残余胆脂瘤的发生率增加情况如下（I期、II期、III期）：松弛部为2%、12%、23%；紧张部组为7%、30%、21%。疾病的严重程度反映在术后听力和复发率的增加上。
2010年JOS分期系统适用于评估初始病理。它对于标准化内陷袋型胆脂瘤的报告以及在结果评估期间调整病情严重程度特别实用。它还可能提供对患者咨询有用的信息。
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