Comparison of EAONO/JOS and ChOLE Classifications in Cholesteatoma in Terms of Intraoperative Findings and Postoperative Results.

Purpose: In recent years, various classifications have been proposed for cholesteatoma staging, including the European Academy of Otology and Neurotology and the Japanese Society of Otology (EAONO/JOS) system and the ChOLE system. The objective of our study is to compare these two staging systems in terms of surgical technique, intraoperative findings, postoperative results, and recidivism.

Methods: Patients aged 18 and above who underwent surgery at our hospital for chronic otitis media with histopathologically confirmed cholesteatoma between January 2016 and January 2021 were included in the study. The cholesteatoma stage was retrospectively determined using the EAONO/JOS and ChOLE systems. Surgical techniques, intraoperative findings, presence of recidivism within one year, pre- and postoperative air and bone conduction thresholds (ACT and BCT) and air-bone gap (ABG) were examined.

Results: As the ChOLE stage increases, the frequency of each of the intraoperative findings (facial canal dehiscence, LSSK fistula, tegmen defect, external auditory canal erosion) increases. As the EAONO/JOS stage increases, only the incidence of facial canal dehiscence and external auditory canal erosion increases. As the EAONO/JOS stage increases, ACT and BCT and ABG increase. As the ChOLE stage increases, ACT and BCT values increase. Additionally, as the stage increased in both systems, CWD techniques were performed more frequently in surgery.

Conclusion: According to our study, ChOLE is more correlated with intraoperative findings and EAONO/JOS is more correlated with audiological results. Although there is no correlation between these stagings and recidivism, both staging systems are related to surgical technique.