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KMID : 0361020190620110617
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Korean Journal of Otolaryngology - Head and Neck Surgery
2019 Volume.62 No. 11 p.617 ~ p.623
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Usefulness of a Novel Staging System for Congenital Cholesteatoma of the Middle Ear
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Kim Byeong-Joon
Han Ju-Ho
Yang Jeong-Hwan
Hong Sung-Kwang
Lee Hyo-Jeong
Kim Hyung-Jong
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Abstract
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Background and Objectives: Although there are number of studies on the risk factors ofrecidivism in the congenital middle ear cholesteatoma, few have focused on the staging system. In this study, we aimed to investigate the postoperative recurrence rate in surgical casesof congenital middle ear cholesteatoma, and compare the results of using the Potsic stagingsystem with those of a novel Kim staging system. Additionally, we also studied to see if theKim staging system could suggest an appropriate surgical approach for each stage.
Subjects and Method: Surgical cases of the disease from January, 1989 to August, 2017performed at Kangdong Sacred Heart or Hallym University Sacred Heart Hospital were includedand those data were retrospectively reviewed. All the cases were pre-operatively assignedto the stages using both Potsic and Kim staging system, retrospectively. The post-operativerecurrence rate was analyzed for each subject according to the findings of one year aftersurgery using both staging systems. Additionally, surgical approach performed in these cases,such as mastoidectomy and/or ossiculoplasty were analyzed and compared among the stagegroups of Kim staging system.
Results: The Potsic staging system showed that recurrence was significantly lower in thestage I than in the other stages, and the Kim staging system showed that recurrence was significantlyhigher in the revision R stage than in the primary A, P, and M stages. The Kim stagingsystem showed that mastoidectomy was performed more frequently in the M stage, andossiculoplasty was performed less frequently in the A stage than in the other stages.
Conclusion Although Potsic and Kim staging systems were both useful for predicting prognosis,the Kim staging system can additionally provide a clue for an appropriate surgical approachfor each stage.
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KEYWORD
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Cholesteatoma, Classification, Congenital, Recurrence
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