Komori Manabu, Tada Takeshi, Koizumi Hiromi, Takahashi Masahiro, Sanpei Sayaka, Morino Tsunetaro, Motegi Masaomi, Miura Masahiro, Yamamoto Kazuhisa, Sakurai Yuika, Yaguchi Yuichiro, Yamamoto Yutaka, Kojima Hiromi
a Department of Otorhinolaryngology , Jikei University School of Medicine , Tokyo , Japan.
Acta Otolaryngol. 2018 Nov;138(11):977-980. doi: 10.1080/00016489.2018.1498593. Epub 2019 Feb 11.
The Japan Otology Society (JOS) proposed the classification and staging system for middle ear cholesteatoma. However, there was little analysis of the pathology of cholesteatoma using this staging system.
AIMS/OBJECTIVES: To analyze the pathology of pars flaccida cholesteatoma using the staging system by JOS.
A total of 183 cases of fresh pars flaccida cholesteatoma treated between January 2009 and December 2015 were included. We used the staging system recommended by JOS (2015). The association of the following variables in each stage of pars flaccida cholesteatoma was examined: age, gender, preoperative hearing level, staging, statuses of mastoid cell growth and stapes, tympanic sinus invasion.
Stage II disease showed the highest degree of progression, and peak incidence was observed in the third and fourth decades of life. Stage III significantly increased after the age of 40 years. The progression of the disease stage was significantly associated with deterioration of hearing level. Cholesteatoma invasion to tympanic sinus was recognized in 14.2% of cases. The state of the stapes is increasingly likely be to fracture as stage progresses.
The JOS Staging System appropriately reflects the disease state, and it was found to be clinically meaningful in this study.
日本耳科学会（JOS）提出了中耳胆脂瘤的分类和分期系统。然而，使用该分期系统对胆脂瘤病理学的分析较少。
使用JOS的分期系统分析松弛部胆脂瘤的病理学。
纳入2009年1月至2015年12月期间治疗的183例新鲜松弛部胆脂瘤病例。我们使用了JOS（2015）推荐的分期系统。检查了松弛部胆脂瘤各阶段以下变量之间的关联：年龄、性别、术前听力水平、分期、乳突气房生长和镫骨状态、鼓窦侵犯情况。
II期疾病显示出最高程度的进展，在第三和第四个十年观察到发病高峰。40岁以后III期显著增加。疾病阶段的进展与听力水平的恶化显著相关。14.2%的病例中发现胆脂瘤侵犯鼓窦。随着分期进展，镫骨骨折的可能性越来越大。
JOS分期系统适当地反映了疾病状态，并且在本研究中发现具有临床意义。
