Long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery

Objectives This study investigated the long-term surgical outcomes of functional cholesteatoma surgery with canal wall reconstruction using autologous bone grafts as the primary material in patients with acquired cholesteatoma. Subjects and Methods Medical charts were retrospectively reviewed for al...

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Autores principales:	Wei-Che Lan, Ching-Yuan Wang, Ming-Hsui Tsai, Chia-Der Lin
Formato:	article
Lenguaje:	EN
Publicado:	PeerJ Inc. 2021
Materias:	Cholesteatoma Surgery Hearing Prognosis Long-term Medicine R
Acceso en línea:	https://doaj.org/article/a91e01d572ee435bbeb7f7e6bf7c836c
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spelling	oai:doaj.org-article:a91e01d572ee435bbeb7f7e6bf7c836c2021-11-25T15:05:24ZLong-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery10.7717/peerj.125222167-8359https://doaj.org/article/a91e01d572ee435bbeb7f7e6bf7c836c2021-11-01T00:00:00Zhttps://peerj.com/articles/12522.pdfhttps://peerj.com/articles/12522/https://doaj.org/toc/2167-8359Objectives This study investigated the long-term surgical outcomes of functional cholesteatoma surgery with canal wall reconstruction using autologous bone grafts as the primary material in patients with acquired cholesteatoma. Subjects and Methods Medical charts were retrospectively reviewed for all patients admitted to one institution for surgical intervention between 2010 and 2018. We analyzed 66 patients (66 ears) who underwent functional tympanomastoidectomy involving the use of autologous bone grafts for canal wall defect reconstruction. Surgical outcomes were evaluated by comparing preoperative audiometric results with follow-up data (at least 36 months after surgery). Logistic regression analyses were performed to determine prognostic factors related to long-term hearing success. These factors included classification and stage of cholesteatoma, stapes condition, ossicular chain damage, active infection of the middle ear, state of the contralateral ear, preoperative hearing thresholds, gender, and age. Results The mean follow-up period was 49.2 months. The recidivism rate was 6% (four of 66 ears). The pure-tone average significantly improved from 50.78 ± 19.98 to 40.81 ± 21.22 dB hearing level (HL; p < 0.001). Air–bone gaps significantly improved from 26.26 ± 10.53 to 17.58 ± 8.21 dB HL (p < 0.001). In multivariate logistic regression analysis, early-stage disease (p = 0.021) and pars flaccida cholesteatoma (p = 0.036) exhibited statistically significant correlations with successful hearing preservation. Conclusion Functional cholesteatoma surgery with autologous bone grafts reconstruction is an effective approach to significantly improve hearing with low recidivism rates. Localized disease and pars flaccida cholesteatoma were two independent predictors of successful hearing preservation.Wei-Che LanChing-Yuan WangMing-Hsui TsaiChia-Der LinPeerJ Inc.articleCholesteatomaSurgeryHearingPrognosisLong-termMedicineRENPeerJ, Vol 9, p e12522 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cholesteatoma Surgery Hearing Prognosis Long-term Medicine R
spellingShingle	Cholesteatoma Surgery Hearing Prognosis Long-term Medicine R Wei-Che Lan Ching-Yuan Wang Ming-Hsui Tsai Chia-Der Lin Long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery
description	Objectives This study investigated the long-term surgical outcomes of functional cholesteatoma surgery with canal wall reconstruction using autologous bone grafts as the primary material in patients with acquired cholesteatoma. Subjects and Methods Medical charts were retrospectively reviewed for all patients admitted to one institution for surgical intervention between 2010 and 2018. We analyzed 66 patients (66 ears) who underwent functional tympanomastoidectomy involving the use of autologous bone grafts for canal wall defect reconstruction. Surgical outcomes were evaluated by comparing preoperative audiometric results with follow-up data (at least 36 months after surgery). Logistic regression analyses were performed to determine prognostic factors related to long-term hearing success. These factors included classification and stage of cholesteatoma, stapes condition, ossicular chain damage, active infection of the middle ear, state of the contralateral ear, preoperative hearing thresholds, gender, and age. Results The mean follow-up period was 49.2 months. The recidivism rate was 6% (four of 66 ears). The pure-tone average significantly improved from 50.78 ± 19.98 to 40.81 ± 21.22 dB hearing level (HL; p < 0.001). Air–bone gaps significantly improved from 26.26 ± 10.53 to 17.58 ± 8.21 dB HL (p < 0.001). In multivariate logistic regression analysis, early-stage disease (p = 0.021) and pars flaccida cholesteatoma (p = 0.036) exhibited statistically significant correlations with successful hearing preservation. Conclusion Functional cholesteatoma surgery with autologous bone grafts reconstruction is an effective approach to significantly improve hearing with low recidivism rates. Localized disease and pars flaccida cholesteatoma were two independent predictors of successful hearing preservation.
format	article
author	Wei-Che Lan Ching-Yuan Wang Ming-Hsui Tsai Chia-Der Lin
author_facet	Wei-Che Lan Ching-Yuan Wang Ming-Hsui Tsai Chia-Der Lin
author_sort	Wei-Che Lan
title	Long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery
title_short	Long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery
title_full	Long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery
title_fullStr	Long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery
title_full_unstemmed	Long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery
title_sort	long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery
publisher	PeerJ Inc.
publishDate	2021
url	https://doaj.org/article/a91e01d572ee435bbeb7f7e6bf7c836c
work_keys_str_mv	AT weichelan longtermfollowupofapplyingautologousbonegraftsforreconstructingtympanomastoiddefectsinfunctionalcholesteatomasurgery AT chingyuanwang longtermfollowupofapplyingautologousbonegraftsforreconstructingtympanomastoiddefectsinfunctionalcholesteatomasurgery AT minghsuitsai longtermfollowupofapplyingautologousbonegraftsforreconstructingtympanomastoiddefectsinfunctionalcholesteatomasurgery AT chiaderlin longtermfollowupofapplyingautologousbonegraftsforreconstructingtympanomastoiddefectsinfunctionalcholesteatomasurgery
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Long-term follow-up of applying autologous bone grafts for reconstructing tympanomastoid defects in functional cholesteatoma surgery

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