EAONO/JOS、STAMCO 和 ChOLE 胆脂瘤分期系统在儿童获得性中耳胆脂瘤预后评估中的比较。

Comparison of the EAONO/JOS, STAMCO and ChOLE cholesteatoma staging systems in the prognostic evaluation of acquired middle ear cholesteatoma in children.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Rd, Xicheng District, Beijing, 100045, China.

Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China.

出版信息

Eur Arch Otorhinolaryngol. 2022 Dec;279(12):5583-5590. doi: 10.1007/s00405-022-07400-z. Epub 2022 May 13.

DOI:10.1007/s00405-022-07400-z

PMID:35554663

Abstract

OBJECTIVE

To compare the performance of the EAONO/JOS, STAMCO, and ChOLE Cholesteatoma Staging Systems in prognostic evaluation of children acquired middle ear cholesteatoma after primary surgery and identify the other factors that could predict cholesteatoma recidivism. And the correlation between the staging and the recidivism of cholesteatoma after grouping according to operation was evaluated.

METHODS

A total of 123 ears of 118 patients that underwent surgery for primary cholesteatoma from November 2008 to May 2020 were included in this retrospective study, and then classified and staged according to the EAONO/JOS, STAMCO, and ChOLE cholesteatoma staging system, respectively. Each indicator involved in the system above was analyzed separately to evaluate its prognostic value for cholesteatoma recidivism.

RESULTS

The type of surgical procedure performed (P = 0.020) was shown to be associated with cholesteatoma recidivism. Cholesteatoma location the supratubal recess (S1) (P = 0.026, HR = 3.614, 95% CI 1.137, 7.945), and the sinus tympani (S2) (P = 0.004, HR = 4.208, 95% CI 1.574, 11.250) were shown to be significantly associated with disease recidivism. When focusing on the CWU operation group, ossicular chain status in STAMCO stage (P = 0.043) and in the ChOLE stage (P = 0.018) were significantly associated with cholesteatoma recidivism. The results had shown no association between the three stages and cholesteatoma recidivism in the CWD and endoscopic surgery groups.

CONCLUSIONS

Based on our study, the EAONO/JOS, STAMCO, and ChOLE Classifications have limited value in predicting cholesteatoma recidivism, in acquired middle ear cholesteatoma in children. Adding the pathological status of the ossicular chain may be useful for predicting the recidivism of cholesteatoma. Additional validation studies are entailed to definitively assess the clinical utility of these classifications.

摘要

目的

比较 EAONO/JOS、STAMCO 和 ChOLE 胆脂瘤分期系统在儿童获得性中耳胆脂瘤初次手术后的预后评估中的性能，并确定其他可预测胆脂瘤复发的因素。并根据手术分组评估分期与胆脂瘤复发之间的相关性。

方法

回顾性分析 2008 年 11 月至 2020 年 5 月期间因原发性胆脂瘤接受手术的 118 例患者的 123 耳，分别按 EAONO/JOS、STAMCO 和 ChOLE 胆脂瘤分期系统进行分类和分期。分别分析上述系统中涉及的每个指标，以评估其对胆脂瘤复发的预后价值。

结果

手术方式（P=0.020）与胆脂瘤复发有关。鼓窦上隐窝（S1）（P=0.026，HR=3.614，95%CI 1.137，7.945）和鼓窦（S2）（P=0.004，HR=4.208，95%CI 1.574，11.250）的胆脂瘤位置与疾病复发显著相关。当关注 CWU 手术组时，STAMCO 分期（P=0.043）和 ChOLE 分期（P=0.018）的听小骨链状态与胆脂瘤复发显著相关。在 CWD 和内镜手术组中，三个分期与胆脂瘤复发之间无关联。