The investigation of the recurrence rate of cholesteatoma using Kaplan-Meier survival analysis.
OBJECTIVE
To investigate the recurrence rate of cholesteatoma using Kaplan-Meier survival analysis.


METHODS
Retrospective study.


METHODS
Tertiary referral center.


METHODS
Three hundred forty-five patients with middle ear cholesteatoma operated on by the same surgeon between 1987 and 2002.


METHODS
The cumulative recurrence rate of cholesteatoma during a 5-year follow-up period was calculated using Kaplan-Meier survival analysis.


RESULTS
The overall 5-year recurrence rate was 11.8%. The recurrence rate increased with the follow-up time. The 5-year recurrence rate was 3.9% in patients treated with canal wall down tympanoplasty (CWDT) and 16.7% in patients treated with intact canal wall tympanoplasty (ICWT) or canal wall reconstruction (CWR) after CWDT with a significant difference (p < 0.01). The 5-year recurrence rate was 26.0% in patients operated on between 1987 and 1996 and 0.7% in patients operated on between 1997 and 2002, again with a significant difference (p < 0.001).


CONCLUSIONS
Kaplan-Meier survival analysis should be used for calculating the recurrence rate of cholesteatoma. Although this analytic method further demonstrates that CWDT is a more reliable surgical method than ICWT/CWR in reducing cholesteatoma recurrence, clinical judgment should be exercised, and we continue to recommend that a flexible approach should be adopted in deciding whether to perform CWDT or ICWT/CWR for individual cases.
Mishiro
Yasuo
Y
Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. ymishiro@hyo-med.ac.jp
Sakagami
Masafumi
M
Kitahara
Tadashi
T
Kondoh
Kazumasa
K
Okumura
Shin-ichi
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014433:Tympanoplasty; D055815:Young Adult