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吸鼻相关胆脂瘤的发病率与临床特征:一项前瞻性、多中心、观察性研究

Incidence and Clinical Characteristics of Sniff-related Cholesteatoma: A Prospective, Multicenter, Observational Study.

临床研究耳科IF 1.9Q2

文献信息

中文摘要

目的: 由咽鼓管闭合不全导致的习惯性吸鼻是松弛部胆脂瘤发生及术后复发的重要病因因素。本研究旨在探讨在接受手术治疗的松弛部胆脂瘤患者中,与习惯性吸鼻相关的胆脂瘤(吸鼻相关胆脂瘤)的患病率及临床特征。
研究设计: 前瞻性、多中心、观察性研究。
研究场所: 26家三级耳科转诊中心。
患者: 连续纳入128例年龄15岁及以上、新诊断为松弛部胆脂瘤(根据日本耳科学会分期系统为Ib期或更高)的患者。
干预: 无。
主要结局指标: 主要结局为在接受手术治疗的松弛部胆脂瘤患者中吸鼻相关胆脂瘤的患病率。根据是否存在习惯性吸鼻发作及吸鼻试验结果,将患者分为3组:吸鼻相关胆脂瘤(两者均阳性)、非吸鼻相关胆脂瘤(两者均阴性)及其他。比较3组之间的人口学和临床特征,包括年龄和性别。
结果: 在128例患者中,53例(41.4%)被归类为吸鼻相关胆脂瘤。此外,吸鼻相关胆脂瘤组患者显著年轻于非吸鼻相关组。
结论: 在接受手术治疗的松弛部胆脂瘤患者中,约40%患有吸鼻相关胆脂瘤,提示其与咽鼓管闭合不全相关。仔细评估习惯性吸鼻可能对于阐明疾病病理生理学及优化治疗策略(包括术后管理)至关重要。

英文摘要

OBJECTIVE: Habitual sniffing resulting from insufficient Eustachian tube closure is an important etiologic factor in the development and postoperative recurrence of pars flaccida cholesteatoma. In this study, we aimed to investigate the prevalence and clinical characteristics of cholesteatoma associated with habitual sniffing (sniff-related cholesteatoma) among patients with surgically indicated pars flaccida cholesteatoma.
STUDY DESIGN: Prospective, multicenter, observational study.
SETTING: Twenty-six tertiary otologic referral centers.
PATIENTS: A total of 128 consecutive patients aged 15 years or above with newly diagnosed pars flaccida cholesteatoma (stage Ib or higher according to the Japan Otological Society staging system) were included.
INTERVENTIONS: None.
MAIN OUTCOME MEASURES: The primary outcome was the prevalence of sniff-related cholesteatoma among patients with surgically indicated pars flaccida cholesteatoma. Patients were classified into 3 groups based on the presence of habitual sniffing episodes and the results of the sniffing test: sniff-related cholesteatoma (both positive), non-sniff-related cholesteatoma (both negative), and others. Demographic and clinical characteristics, including age and sex, were compared among the 3 groups.
RESULTS: Among the 128 patients, 53 (41.4%) were classified as having sniff-related cholesteatoma. Furthermore, patients in the sniff-related cholesteatoma group were significantly younger than those in the non-sniff-related group.
CONCLUSIONS: Approximately 40% of patients with surgically indicated pars flaccida cholesteatoma had sniff-related cholesteatoma, suggesting an association with insufficient Eustachian tube closure. The careful assessment of habitual sniffing may be essential for elucidating disease pathophysiology and optimizing treatment strategies, including postoperative management.