Aydin Sudabatmaz Esra, Abakay Mehmet Akif, Gulustan Filiz, Yazici Zahide Mine
Bahcelievler State Hospital E.N.T Clinic Istanbul, Istanbul, Turkey.
Bakirkoy Sadi Konuk Research and Training Hospital E.N.T Clinic Istanbul, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2025 Jun 5. doi: 10.1007/s00405-025-09423-8.
In recent years, various classifications have been proposed for cholesteatoma staging, including the European Academy of Otology and Neurotology and the Japanese Society of Otology (EAONO/JOS) system and the ChOLE system. The objective of our study is to compare these two staging systems in terms of surgical technique, intraoperative findings, postoperative results, and recidivism.
Patients aged 18 and above who underwent surgery at our hospital for chronic otitis media with histopathologically confirmed cholesteatoma between January 2016 and January 2021 were included in the study. The cholesteatoma stage was retrospectively determined using the EAONO/JOS and ChOLE systems. Surgical techniques, intraoperative findings, presence of recidivism within one year, pre- and postoperative air and bone conduction thresholds (ACT and BCT) and air-bone gap (ABG) were examined.
As the ChOLE stage increases, the frequency of each of the intraoperative findings (facial canal dehiscence, LSSK fistula, tegmen defect, external auditory canal erosion) increases. As the EAONO/JOS stage increases, only the incidence of facial canal dehiscence and external auditory canal erosion increases. As the EAONO/JOS stage increases, ACT and BCT and ABG increase. As the ChOLE stage increases, ACT and BCT values increase. Additionally, as the stage increased in both systems, CWD techniques were performed more frequently in surgery.
According to our study, ChOLE is more correlated with intraoperative findings and EAONO/JOS is more correlated with audiological results. Although there is no correlation between these stagings and recidivism, both staging systems are related to surgical technique.
近年来，针对胆脂瘤分期提出了多种分类方法，包括欧洲耳科学与神经耳科学学会及日本耳科学会（EAONO/JOS）系统和ChOLE系统。我们研究的目的是在手术技术、术中发现、术后结果和复发率方面比较这两种分期系统。
纳入2016年1月至2021年1月期间在我院接受手术治疗的18岁及以上慢性中耳炎患者，其胆脂瘤经组织病理学确诊。采用EAONO/JOS和ChOLE系统对胆脂瘤分期进行回顾性判定。检查手术技术、术中发现、一年内复发情况、术前和术后气导和骨导阈值（ACT和BCT）以及气骨导差（ABG）。
随着ChOLE分期增加，各术中发现（面神经管裂开、镫骨上结构瘘管、鼓室盖缺损、外耳道侵蚀）的发生率增加。随着EAONO/JOS分期增加，仅面神经管裂开和外耳道侵蚀的发生率增加。随着EAONO/JOS分期增加，ACT、BCT和ABG增加。随着ChOLE分期增加，ACT和BCT值增加。此外，随着两个系统分期增加，手术中更频繁地采用CWD技术。
根据我们的研究，ChOLE与术中发现的相关性更强，而EAONO/JOS与听力学结果的相关性更强。尽管这些分期与复发率之间没有相关性，但两种分期系统均与手术技术相关。
