Frequency and Distribution of Complications in Cholesteatoma Patients: A Tertiary Care Hospital Study

Authors

  • Noshad Ali Jinnah Postgraduate Medical Centre Karachi
  • Saqib Aziz Shaukat Khanum Hospital Lahore.
  • Hurtamina Khan Jinnah Postgraduate Medical Centre Karachi
  • Unsa Iqbal Jinnah Medical and Dental College (Sohail Trust Hospital)
  • Sameer Qureshi Naimat Begum Hamdard University Hospital Karachi
  • Ramsha Shahab Inspire Pakistan Institute Karachi

DOI:

https://doi.org/10.61919/jhrr.v4i1.637

Keywords:

Cholesteatoma, Cholesteatoma complications, Complications, Extracranial complications, Intracranial complications, Ossicular damage, Surgical treatment

Abstract

Background: Cholesteatoma, a benign epithelial lesion, progresses with time, necessitating surgical intervention. The most common surgical treatments are canal wall up (CWU) and canal wall down (CWD). CWU, though preserving ear canal anatomy, has a higher risk of recurrence, prompting a need to evaluate the frequency and nature of complications arising from cholesteatoma to improve treatment outcomes.

Objective: This study aims to identify the frequency and types of complications in patients diagnosed with cholesteatoma at a tertiary care hospital.

Methods: Conducted as a cross-sectional analysis at the Department of ENT, Jinnah Postgraduate Medical Centre, Karachi, from August 10, 2019, to February 9, 2020, this study included 210 diagnosed patients. Through otoscopy, audiologic evaluations, and microscope examinations for selected cases, patients with signs of persistent disease underwent mastoid exploration. Surgical interventions were tailored based on disease extent and type. Statistical analysis employed descriptive statistics, stratification, and Chi-square tests for significance (P-value ≤0.05).

Results: Of the participants, 57.6% were male, and 42.4% were female, with an average age of 31.30±8.75 years and a mean disease duration of 8.73±3.63 months. Extracranial complications were identified in 29% of patients, with 12.4% experiencing ossicular damage. Intracranial complications were found in 18.1% of patients, with meningitis constituting 8.6% of these cases. A total of 5.7% presented with multiple complications. No significant associations were found between the complications and variables such as gender, age, BMI, and disease duration.

Conclusion: Extracranial complications, notably ossicular damage, were most common, followed by intracranial complications and multiple complications, underlining the necessity for early diagnosis and targeted treatment strategies.

Downloads

Download data is not yet available.

Author Biographies

Noshad Ali, Jinnah Postgraduate Medical Centre Karachi

Postgraduate Trainee, Department of ENT, Jinnah Postgraduate Medical Centre Karachi

Saqib Aziz , Shaukat Khanum Hospital Lahore.

Fellow Head and Neck Surgical Oncology, Shaukat Khanum Hospital, Lahore.

Hurtamina Khan, Jinnah Postgraduate Medical Centre Karachi

Assistant Professor, Department of ENT, Jinnah Postgraduate Medical Centre Karachi

Unsa Iqbal, Jinnah Medical and Dental College (Sohail Trust Hospital)

Registrar, Department of ENT, Jinnah Medical and Dental College (Sohail Trust Hospital)

Sameer Qureshi, Naimat Begum Hamdard University Hospital Karachi

Professor, ENT Department, Naimat Begum Hamdard University Hospital Karachi

Ramsha Shahab, Inspire Pakistan Institute Karachi

Medical Officer, Inspire Pakistan Institute Karachi

References

Maniu A, Harabagiu O, Schrepler MP, Catana A, Fanuta B, Mogoanta CA. Molecular biology of cholesteatoma. Rom J Morphol Embryol. 2014;55(1):7-13.

Louw L. Acquired cholesteatoma pathogenesis: stepwise explanations. J Laryngol Otol. 2010;124(6):587-93.

Shibata S, Murakami K, Umeno Y, Komune S. Epidemiological study of cholesteatoma in Fukuoka City. J Laryngol Otol. 2015;129(2):6-11.

Kao R, Wannemuehler T, Yates CW, Nelson RF. Outpatient management of cholesteatoma with canal wall reconstruction tympanomastoidectomy. Laryng Investig Otolaryngol. 2017;2(6):351-7.

Kuo CL, Shiao AS, Yung M, Sakagami M, Sudhoff H, Wang CH. Updates and knowledge gaps in cholesteatoma research. BioMed Res Int. 2015;2015:1-17.

Dornelles C, Costa SS, Meurer L, Schweiger C. Some considerations about acquired adult and pediatric cholesteatomas. Rev Bras Otorrinolaringol. 2005;71(4):536-46.

Bujía J, Holly A, Antolí-Candela F, Tapia MG, Kastenbauer E. Immunobiological peculiarities of cholesteatoma in children: quantification of epithelial proliferation by MIB 1. Laryngoscope. 1996;106(7):865-8.

Walker PC, Mowry SE, Hansen MR, Gantz BJ. Long-term results of canal wall reconstruction tympanomastoidectomy. Otol Neurotol. 2014;35(6):954-60.

Syms MJ, Luxford WM. Management of cholesteatoma: status of the canal wall. Laryngoscope. 2003;113(3):443-8.

Shohet JA. The management of pediatric cholesteatoma. Otolaryngol Clin North Am. 2002;35(4):841-51.

Cody TD, McDonald TJ. Mastoidectomy for acquired cholesteatoma: Follow-Up to 20 years. Laryngoscope. 1984;94(8):1027-9.

Black B, Gutteridge I. Acquired cholesteatoma: classification and outcomes. Otol Neurotol. 2011;32(6):992-5.

Vartiainen E. Ten-year results of canal wall down mastoidectomy for acquired cholesteatoma. Auris Nasus Larynx. 2000;27(3):227-9.

Mustafa A, Kuçi S, Behramaj A. Management of cholesteatoma complications: Our experience in 145 cases. Indian J Otol. 2014;20(2):45-7.

Baig MM. Prevalence of cholesteatoma and its complications in patients of chronic suppurative otitis media. J Rawalpindi Med Coll. 2011;15(1):16-7.

Shenoi PM. Management of chronic suppurative otitis media. In: Scott-Brown's Otolaryngology. 6th ed. Oxford, London, Boston: Butterworth-Heinemann; 1987. p. 215-37.

Cody TR, Taylor WF. Mastoidectomy for acquired cholesteatoma: Long term results. In: McCabe BF, Sade J, Abramson M, editors. Cholesteatoma (Active squamous chronic otitis media), 1st International Conference, Birmingham, Alabama: Aesculapius Publishing Co; 1977. p. 33:51.

Ludman H. Complications of suppurative otitis media. In: Booth JB, editor. Scott Brown’s Otolaryngology. 5th ed. London: Butterworth; 1987. p. 264-91.

Chowdhury MA, Alauddin M. Comparative study between tubotympanic and atticoantral types of chronic suppurative otitis media. Bangl Med Res Counc Bull. 2002;28(1):36-44.

Kangsanarak J, Fooanant S, Ruckphaopunt K. Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases. J Laryngol Otol. 1993;107(11):999-1004.

Roland PS. Middle ear Cholesteatoma [Internet]. Available from: http://emedicine.medscape.com/article/860080-overview.

Kemppainen HO, Puhakka HJ, Laippala PJ. Epidemiology and aetiology of middle ear cholesteatoma. Acta Otolaryngol. 1999;119(5):568-72.

Nyrop M, Bonding P. Extensive cholesteatoma: Long-term results of three surgical techniques. J Laryngol Otol. 1997;111(6):521-6.

Alho OP, Jokinen K, Laitakari K. Chronic suppurative otitis media and cholesteatoma: Vanishing diseases among Western populations? Clin Otolaryngol Allied Sci. 1997;22(4):358-61.

Downloads

Published

2024-03-12

How to Cite

Ali, N., Aziz , S., Khan, H., Iqbal, U., Qureshi, S., & Shahab, R. (2024). Frequency and Distribution of Complications in Cholesteatoma Patients: A Tertiary Care Hospital Study. Journal of Health and Rehabilitation Research, 4(1), 1248–1255. https://doi.org/10.61919/jhrr.v4i1.637