Clinical Staging And Efficacy Of Cholesteatoma Of Middle Ear In Adults

Objective: Investigate the correlation between cholesteatoma clinical staging and surgical method selection and therapeutic effect in adults with middle ear cholesteatoma,so as to clarify the guiding significance of clinical staging on surgical method selection and postoperative efficacy evaluation.Methods: Sixty-two patients with middle ear cholesteatoma with complete clinical data who underwent surgery in the ear ward of shengjing hospital affiliated to China medical university from November 2017 to January 2019 and were followed up for more than 6 months after surgery were collected.Preoperative clinical staging was performed according to preoperative imaging examination and EAONO \ JOS staging criteria for middle ear cholesteatoma.To analyze the correlation between preoperative clinical stage of cholesteatoma of middle ear and the choice of operative method,preoperative hearing,postoperative hearing improvement and postoperative dry ear time.SPSS22.0 software was used for statistical analysis of the experimental results.Results: EAONO \ JOS stage in which Ⅱ cases accounted for the most,64.5%(40 cases);The second stage was stage I,accounting for 20.9%(13 cases).Ⅲ accounted for 14.5%(9 cases).Among the 62 patients,52 underwent open mastoid radical resection + tympanoplasty(open mastoid radical resection + tympanoplasty + external auditory canal reconstruction in 41 cases,open mastoid radical treatment + tympanoplasty + auricular cavity plasty in 11 cases),and wall mastoid radical treatment + tympanoplasty in 10 cases.After 6 months of follow-up,46 of the 55 patients who underwent ossicular chain reconstruction at the same time showed significant improvement in hearing,accounting for 83.64%.At 12 months after the surgery,hearing was significantly improved in 34 of the 44 patients who could be followed-up,accounting for 77.27%.The dry ear time of all 62 patients ranged from 2 to 18 weeks,with an average dry ear time of 7.95±3.87 weeks.The clinical stage of middle ear cholesteatoma was positively correlated with the choice of surgical operation,preoperative hearing loss and postoperative dry ear time,but negatively correlated with postoperative hearing improvement.Conclusion: The correlation between preoperative clinical stage of cholesteatoma of middle ear in adults and operative method,postoperative dry ear time and postoperative hearing improvement is obvious.