title: The contralateral ear in cholesteatoma.
abstract: Middle ear cholesteatoma has been extensively studied. Theories of cholesteatoma pathogenesis involving previous tympanic membrane retraction are the most widely accepted, but the contralateral ear in patients with cholesteatoma remains unstudied. This study aimed to investigate the contralateral ear in patients with cholesteatoma, and to determine whether the characteristics of it differ according to patient age and cholesteatoma growth patterns. This study was cross sectional. We evaluated 356 patients with middle ear cholesteatoma in at least one ear, and no history of surgery, between August 2000 and March 2013. Otoendoscopy was conducted on both the affected and the contralateral ear. They were classified as normal, tympanic membrane perforation, moderate to severe tympanic membrane retraction and cholesteatoma. The mean age of the patients was 32.77 years, and 53.1 % of the cohort were female. Only 34.8 % of the contralateral ears were normal. The most common abnormality was moderate to severe tympanic membrane retraction (41.6 %). Cholesteatoma was identified in 16 %. Children exhibited a greater frequency of tympanic membrane retractions, whereas adults exhibited a greater frequency of cholesteatoma. All of the contralateral ears in the anterior epitympanic group were normal, but otherwise there were no differences in the contralateral ear when we compared the cholesteatoma growth patterns. We conclude that patients diagnosed with acquired cholesteatoma of one ear are significantly more likely to exhibit abnormalities of the contralateral ear.
authors.affiliation: Department of Otolaryngology and Ophthalmology, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, CEP 90035-003, Brazil.
authors.forename: Sady Selaimen
authors.initials: SS
authors.lastname: da Costa
authors.affiliation: Department of Health and Human Communication, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2777, room 315, Santa Cecília, Porto Alegre, RS, CEP 90035-007, Brazil.
authors.forename: Adriane Ribeiro
authors.initials: AR
authors.lastname: Teixeira
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, zona 19, Bairro Santa Cecília, Porto Alegre, RS, CEP 90035-903, Brazil. leticiarosito@gmail.com.
authors.forename: Letícia Petersen Schmidt
authors.initials: LP
authors.lastname: Rosito
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D038781:Otoscopy / Q000379:methods*; D014432:Tympanic Membrane / Q000000981:diagnostic imaging / Q000473:pathology; D018058:Tympanic Membrane Perforation / Q000175:diagnosis
keywords: Cholesteatoma; Contralateral ear; Growth pattern; Tympanic membrane retraction