Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2025
Recurrence Rate of Congenital Cholesteatoma: A Kaplan-Meier Survival Analysis.
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Kamakura Takefumi, Sakagami Masafumi, Tsuzuki Kenzo, Inohara Hidenori, Mishiro Yasuo
Аннотация
OBJECTIVE: The aim of this study was to evaluate the recurrence rate of congenital cholesteatoma using Kaplan-Meier survival analysis.
STUDY DESIGN: Retrospective study.
SETTING: Tertiary referral center.
PATIENTS: Eighty-one patients with middle ear congenital cholesteatoma underwent surgery or had surgeries supervised by the same surgeon from 1991 to 2021.
INTERVENTIONS: The patients underwent tympanoplasty.
MAIN OUTCOME MEASURES: The cumulative recurrence rate of congenital cholesteatoma was calculated using Kaplan-Meier survival analysis.
RESULTS: The 7-year recurrence rates of residual and retraction cholesteatoma were 11.0% and 14.9%, respectively. The overall 5-year and 7-year recurrence rates were 17.1% and 25.4%, respectively. No recurrence occurred beyond 7 years after surgery. The 7-year recurrence rates of retraction cholesteatoma were 24.2% and 0.0% in patients who underwent surgery from 1991 to 2010 and from 2011 to 2021, respectively (log-rank test: P =0.014). The overall recurrence rates were 5.3% for stages I and II and 31.1% for stages III and IV (log-rank test: P =0.082). Residual cholesteatoma occurred in 9 patients, whereas retraction cholesteatoma was observed in seven. The median time to retraction cholesteatoma was significantly longer than that to residual cholesteatoma (Mann-Whitney U test: P =0.029).
CONCLUSIONS: Kaplan-Meier survival analysis revealed that recurrence rates increased with longer observation periods. Although no recurrence occurred beyond 7 years, long-term follow-up is recommended. Kaplan-Meier survival analysis should be used to account for censored data when evaluating recurrence rates of congenital cholesteatoma.
STUDY DESIGN: Retrospective study.
SETTING: Tertiary referral center.
PATIENTS: Eighty-one patients with middle ear congenital cholesteatoma underwent surgery or had surgeries supervised by the same surgeon from 1991 to 2021.
INTERVENTIONS: The patients underwent tympanoplasty.
MAIN OUTCOME MEASURES: The cumulative recurrence rate of congenital cholesteatoma was calculated using Kaplan-Meier survival analysis.
RESULTS: The 7-year recurrence rates of residual and retraction cholesteatoma were 11.0% and 14.9%, respectively. The overall 5-year and 7-year recurrence rates were 17.1% and 25.4%, respectively. No recurrence occurred beyond 7 years after surgery. The 7-year recurrence rates of retraction cholesteatoma were 24.2% and 0.0% in patients who underwent surgery from 1991 to 2010 and from 2011 to 2021, respectively (log-rank test: P =0.014). The overall recurrence rates were 5.3% for stages I and II and 31.1% for stages III and IV (log-rank test: P =0.082). Residual cholesteatoma occurred in 9 patients, whereas retraction cholesteatoma was observed in seven. The median time to retraction cholesteatoma was significantly longer than that to residual cholesteatoma (Mann-Whitney U test: P =0.029).
CONCLUSIONS: Kaplan-Meier survival analysis revealed that recurrence rates increased with longer observation periods. Although no recurrence occurred beyond 7 years, long-term follow-up is recommended. Kaplan-Meier survival analysis should be used to account for censored data when evaluating recurrence rates of congenital cholesteatoma.