Mammarella Fulvio, Loperfido Antonella, Zelli Melissa, Pianura Claudio Maria, Bellocchi Gianluca
Department of Otolaryngology, San Camillo Forlanini Hospital, Rome, ITA.
Cureus. 2020 Dec 27;12(12):e12317. doi: 10.7759/cureus.12317.
There are many classifications for cholesteatomatous otitis media but none correspond exactly to the formulation of a surgical protocol for the middle ear and mastoid nor are any specific for the extension of the otitis media, making it difficult to interpret the published results. All the available classifications are limited to the cholesteatoma and, moreover, the variety of the reported studies in literature does not allow a standardization to define middle ear pathology and surgical procedures. The aim of this paper is to propose a novel staging system for middle ear diseases paying attention to the involvement of tympanic Cavity (C), Attic (A), and Mastoid (M): the CAM classification. In particular, CAM classification is composed of three symbols (0 / + / ρ) and two letters (t and m, tiny and ivory mastoid cases) related to the alphabetic initial of the macroscopic region, being able to allow a clear and specific description of the local situation. Moreover, the possibility to describe the temporal bone and the potential use of sub-groups to specifically define the involvement of the tympanic cavity and the attic could allow the creation of a common otologic language among all the different centres.
胆脂瘤型中耳炎有多种分类方法，但没有一种与中耳和乳突手术方案的制定完全对应，也没有针对中耳炎扩展情况的具体分类，这使得解读已发表的结果变得困难。所有现有的分类都局限于胆脂瘤，此外，文献中报道的研究种类繁多，无法实现对中耳病理和手术程序进行标准化定义。本文的目的是提出一种针对中耳疾病的新分期系统，重点关注鼓室（C）、上鼓室（A）和乳突（M）的受累情况：即CAM分类。具体而言，CAM分类由三个符号（0 / + / ρ）和两个字母（t和m，分别代表微小乳突病例和骨质硬化型乳突病例）组成，这些符号和字母与宏观区域的字母首字母相关，能够清晰、具体地描述局部情况。此外，描述颞骨的可能性以及使用亚组来明确界定鼓室和上鼓室受累情况的潜在用途，可能会促使所有不同中心之间形成一种通用的耳科学语言。
