Recurrence Rate of Congenital Cholesteatoma: A Kaplan-Meier Survival Analysis

The aim of this study was to evaluate the recurrence rate of congenital cholesteatoma using Kaplan-Meier survival analysis.

Retrospective study.

Tertiary referral center.

Eighty-one patients with middle ear congenital cholesteatoma underwent surgery or had surgeries supervised by the same surgeon from 1991 to 2021.

The patients underwent tympanoplasty.

The cumulative recurrence rate of congenital cholesteatoma was calculated using Kaplan-Meier survival analysis.

The 7-year recurrence rates of residual and retraction cholesteatoma were 11.0% and 14.9%, respectively. The overall 5-year and 7-year recurrence rates were 17.1% and 25.4%, respectively. No recurrence occurred beyond 7 years after surgery. The 7-year recurrence rates of retraction cholesteatoma were 24.2% and 0.0% in patients who underwent surgery from 1991 to 2010 and from 2011 to 2021, respectively (log-rank test: P =0.014). The overall recurrence rates were 5.3% for stages I and II and 31.1% for stages III and IV (log-rank test: P =0.082). Residual cholesteatoma occurred in 9 patients, whereas retraction cholesteatoma was observed in seven. The median time to retraction cholesteatoma was significantly longer than that to residual cholesteatoma (Mann-Whitney U test: P =0.029).

Kaplan-Meier survival analysis revealed that recurrence rates increased with longer observation periods. Although no recurrence occurred beyond 7 years, long-term follow-up is recommended. Kaplan-Meier survival analysis should be used to account for censored data when evaluating recurrence rates of congenital cholesteatoma.