Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.
Otol Neurotol. 2023 Jul 1;44(6):e393-e397. doi: 10.1097/MAO.0000000000003908. Epub 2023 May 28.
To analyze the time trends of recidivism of acquired cholesteatoma using the Kaplan-Meier method.
We conducted a retrospective, observational study of 256 patients having their first cholesteatoma surgery. The cumulative recidivism-free rate was calculated using Kaplan-Meier survival analysis related to the follow-up period, pathophysiology, the extent of the disease, and recidivism pathologies.
Pars flacida cholesteatoma with tympanic cavity progression had a high likelihood of recurrence disease. Pars tensa cholesteatoma led to more recurrence of the disease than the residual disease. In both pars flacida and pars tensa cholesteatoma, the incidence of disease recurrence increased even 3 years after surgery. On the contrary, the incidence of residual disease peaked within 3 years after surgery, and thereafter, the incidence of residual disease tended to be small. In particular, pars flacida cholesteatoma extending into the mastoid cavity or tympanic cavity tended to recur up to 5 years postoperatively.
We calculated the cumulative recidivism-free rates of 256 patients with cholesteatoma using Kaplan-Meier survival analysis. These results can lead to better estimates of the length of the follow-up period.
Level IV evidence from case-control studies.
采用 Kaplan-Meier 法分析后天性胆脂瘤复发的时间趋势。
我们对 256 例首次行胆脂瘤手术的患者进行了回顾性、观察性研究。采用 Kaplan-Meier 生存分析法，根据随访时间、病理生理学、疾病程度和复发病理对无复发生存率进行计算。
鼓膜松弛部胆脂瘤伴鼓室腔进展具有较高的复发疾病可能性。鼓膜紧张部胆脂瘤比残留病变更易导致疾病复发。在鼓膜松弛部和鼓膜紧张部胆脂瘤中，即使在手术后 3 年内，疾病复发的发生率也在增加。相反，残留病变的发生率在手术后 3 年内达到峰值，此后，残留病变的发生率趋于较小。特别是，延伸至乳突腔或鼓室腔的鼓膜松弛部胆脂瘤在术后 5 年内有复发的倾向。
我们使用 Kaplan-Meier 生存分析法计算了 256 例胆脂瘤患者的无复发累积率。这些结果可以更好地估计随访时间的长度。
来自病例对照研究的 IV 级证据。
