Risk of recurrence in surgically treated Middle-ear Cholesteatomas -  A retrospective cohort study

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Abstract

Cholesteatomas are benign tumors in the temporal bone which can damage surrounding structures through inflammatory, osteolytic activity. Surgery is the only curative treatment, but there is potential for recurrence. This study aimed to investigate the risk of recurrence after surgically treated middle-ear cholesteatoma in order to evaluate the need for post-operative follow-up. Medical records of patients with the diagnosis middle-ear cholesteatoma were thoroughly and systematically reviewed to gather information about surgery until recurrence, death or end of follow-up. Data was analysed by performing a time-to-event analysis and descriptive statistics. We found that among 267 included patients, 20% had recurrent disease. Stratified by age, 18% of the adults and 36% of the children experienced recurrence, with 78% of adults and 39% of children experiencing recurrence beyond the recommended follow-up time of 2 and 5 years, respectively. Children had a significantly higher risk of recurrence compared to adults. The majority of patients with recurrence were treated with mastoidectomy. In conclusion, the recurrence rate after cholesteatoma surgery is 20%, in accordance with previous findings. A prolonged, age-stratified and more systematic follow-up is suggested considering the high risk of recurrence in children compared to adults.

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