IMPORTANCE: The ideal surgical treatment of cholesteatoma has been subject to discussion for years because both traditional surgical techniques (canal wall down [CWD] and canal wall up [CWU] tympanoplasty) have their own advantages and disadvantages. A more recently propagated surgical approach, to combine the CWD or CWU tympanoplasty technique with obliteration of the mastoid and epitympanum, is showing promising results. OBJECTIVE: To systematically review the literature on recurrent and residual cholesteatoma rates after single-stage CWU and CWD tympanoplasty with mastoid obliteration. EVIDENCE REVIEW: A systematic search of literature was performed to identify relevant publications in multiple electronic databases. The initial search was conducted in December 2016 and was updated in July 2017. Each study was reviewed by 2 independent reviewers on predetermined eligibility criteria. The methodological quality was determined using the methodological index for nonrandomized studies (MINORS) scale, and the relevance to the current topic was determined using a 4-criterion checklist. FINDINGS: The searches identified a total of 336 potentially relevant publications; 190 articles were excluded based on title and abstract. The full-text articles of the remaining 146 citations were assessed for eligibility, resulting in 22 articles. After assessing these remaining articles for methodological quality and relevance to the current topic, another 8 studies were excluded, and a total of 13 studies (1534 patients) were included. Of the 1534 patients who underwent CWD or CWU tympanoplasty with mastoid obliteration, the rate of recurrent disease was 4.6%, and the rate of residual disease was 5.4%. In CWU tympanoplasty with mastoid obliteration, these rates were 0.28% and 4.2%, respectively and in CWD tympanoplasty with mastoid obliteration, 5.9% and 5.8%, respectively. CONCLUSIONS AND RELEVANCE: We show the recurrent and residual disease rates after either CWU or CWD tympanoplasty with mastoid obliteration to be qualitatively similar to, if not better than, previously reported rates of for nonobliterative techniques. In this study, the lowest recurrent and residual rates were reported when combining the CWU tympanoplasty with mastoid obliteration, on average 0.28 and 4.2%, respectively.
IMPORTANCE: The ideal surgical treatment of cholesteatoma has been subject to discussion for years because both traditional surgical techniques (canal wall down [CWD] and canal wall up [CWU] tympanoplasty) have their own advantages and disadvantages. A more recently propagated surgical approach, to combine the CWD or CWU tympanoplasty technique with obliteration of the mastoid and epitympanum, is showing promising results. OBJECTIVE: To systematically review the literature on recurrent and residual cholesteatoma rates after single-stage CWU and CWD tympanoplasty with mastoid obliteration. EVIDENCE REVIEW: A systematic search of literature was performed to identify relevant publications in multiple electronic databases. The initial search was conducted in December 2016 and was updated in July 2017. Each study was reviewed by 2 independent reviewers on predetermined eligibility criteria. The methodological quality was determined using the methodological index for nonrandomized studies (MINORS) scale, and the relevance to the current topic was determined using a 4-criterion checklist. FINDINGS: The searches identified a total of 336 potentially relevant publications; 190 articles were excluded based on title and abstract. The full-text articles of the remaining 146 citations were assessed for eligibility, resulting in 22 articles. After assessing these remaining articles for methodological quality and relevance to the current topic, another 8 studies were excluded, and a total of 13 studies (1534 patients) were included. Of the 1534 patients who underwent CWD or CWU tympanoplasty with mastoid obliteration, the rate of recurrent disease was 4.6%, and the rate of residual disease was 5.4%. In CWU tympanoplasty with mastoid obliteration, these rates were 0.28% and 4.2%, respectively and in CWD tympanoplasty with mastoid obliteration, 5.9% and 5.8%, respectively. CONCLUSIONS AND RELEVANCE: We show the recurrent and residual disease rates after either CWU or CWD tympanoplasty with mastoid obliteration to be qualitatively similar to, if not better than, previously reported rates of for nonobliterative techniques. In this study, the lowest recurrent and residual rates were reported when combining the CWU tympanoplasty with mastoid obliteration, on average 0.28 and 4.2%, respectively.
Authors: Victor J Kroon; Steven W Mes; Pepijn A Borggreven; Rick van de Langenberg; David R Colnot; Jasper J Quak Journal: Eur Arch Otorhinolaryngol Date: 2022-10-08 Impact factor: 3.236
Authors: Jantine J Lindeboom; P M W van Kempen; J Buwalda; B O Westerlaken; D A van Zuijlen; S J H Bom; F B van der Beek Journal: Eur Arch Otorhinolaryngol Date: 2022-09-29 Impact factor: 3.236
Authors: Patrick Rønde Møller; Christina Nygaard Pedersen; Line R Grosfjeld; Christian E Faber; Bjarki D Djurhuus Journal: Int Arch Otorhinolaryngol Date: 2019-12-20
Authors: Fleur A Ten Tije; Sietze Alkema; Lisa van der Putten; Jan Pieter Koopman; Joeri Buwalda; Sophia E Kramer; Robert Jan Pauw; Paul Merkus Journal: Eur Arch Otorhinolaryngol Date: 2020-06-11 Impact factor: 2.503
Authors: Hylke F E van der Toom; Marc P van der Schroeff; Mick Metselaar; Anne van Linge; Jantien L Vroegop; Robert J Pauw Journal: Eur Arch Otorhinolaryngol Date: 2022-04-10 Impact factor: 3.236