Evaluating long-term recurrence of cholesteatoma following primary surgery: an umbrella review of surgical techniques and patient factors.

IF 1.1 4区医学 Q3 OTORHINOLARYNGOLOGY

Journal of Laryngology and Otology Pub Date : 2026-08-01 DOI:10.1017/S0022215126105234

Edi Handoko, Rizki Ekaputra Handoko, Ahmad Dian Wahyudi

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引用次数: 0

Abstract

Objectives: This study aimed to synthesise existing systematic reviews to determine the true long-term recurrence rate of cholesteatoma following primary surgery and to evaluate the comparative effectiveness of surgical approaches (canal wall up vs canal wall down ) and adjunctive procedures on disease recidivism.

Methods: A systematic search of PubMed, Scopus and OpenAlex identified 23 studies (predominantly systematic reviews and meta-analyses) encompassing 12,819 patients with an equal to or greater than 12 months' follow-up and clearly defined recurrence, evaluating canal wall up, canal wall down, mastoid obliteration and endoscopic assistance.

Results: Recurrence increased from 7 per cent at 12 months to 39 per cent at 15 years. Canal wall down showed lower recurrence than canal wall up. Mastoid obliteration (odds ratio, 0.33-0.45) and endoscopic techniques (risk ratio, 0.48-0.68) reduced recidivism and residual disease. Age and staged surgery increased risk, whereas planned second-look surgery was protective.

Conclusion: Cholesteatoma recurrence is strongly time-dependent. Combining appropriate surgical techniques with mastoid obliteration, endoscopic assistance and long-term surveillance improves long-term disease control.

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评估原发性手术后胆脂瘤的长期复发：手术技术和患者因素的综合回顾。

目的：本研究旨在综合现有的系统综述，以确定原发性手术后胆脂瘤的真正长期复发率，并评估手术入路（管壁向上vs管壁向下）和辅助手术对疾病再犯的比较有效性。方法：对PubMed、Scopus和OpenAlex进行系统检索，确定了23项研究（主要是系统评价和荟萃分析），包括12819例随访≥12个月且复发明确的患者，评估管壁上升、管壁下降、乳突封堵和内镜辅助。结果：复发率从12个月的7%上升到15年的39%。下管壁复发率低于上管壁复发率。乳突封堵术（优势比，0.33-0.45）和内窥镜技术（风险比，0.48-0.68）减少了再犯和残留疾病。年龄和分期手术增加了风险，而有计划的二次手术则有保护作用。结论：胆脂瘤复发具有较强的时间依赖性。将适当的手术技术与乳突封堵、内镜辅助和长期监测相结合，可改善疾病的长期控制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Laryngology and Otology 医学-耳鼻喉科学

CiteScore

3.20

自引率

11.80%

发文量

593

审稿时长

3-6 weeks

期刊介绍： The Journal of Laryngology & Otology (JLO) is a leading, monthly journal containing original scientific articles and clinical records in otology, rhinology, laryngology and related specialties. Founded in 1887, JLO is absorbing reading for ENT specialists and trainees. The journal has an international outlook with contributions from around the world, relevant to all specialists in this area regardless of the country in which they practise. JLO contains main articles (original, review and historical), case reports and short reports as well as radiology, pathology or oncology in focus, a selection of abstracts, book reviews, letters to the editor, general notes and calendar, operative surgery techniques, and occasional supplements. It is fully illustrated and has become a definitive reference source in this fast-moving subject area. Published monthly an annual subscription is excellent value for money. Included in the subscription is access to the JLO interactive web site with searchable abstract database of the journal archive back to 1887.