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根据EAONO-JOS和SAMEO-ATO分类,使用内镜-显微镜方法管理的初级获得胆固醇瘤的结果
Tyler J Gathman1, Huong Dang2, Nell Adams2
1University of Minnesota School of Medicine, Minneapolis, Minnesota.
概括
无论是EAONO-JOS还是SAMEO-ATO分类系统都没有预测胆固醇瘤的复发. 然而,对于初级获得性胆固醇瘤手术的独家内镜方法,与组合方法相比,修订的次数较少.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术创新 在外科创新.
- 医学分类系统 医学分类系统
背景情况:
- 初级获得性胆固醇瘤需要有效的手术管理和可靠的结果预测.
- 目前的分类系统,如欧洲耳科和神经病学会-日本耳科学会 (EAONO-JOS) 和SAMEO-ATO),旨在标准化外科评估.
- 对比内镜和联合手术方法对于优化患者的治疗结果至关重要.
研究的目的:
- 评估EAONO-JOS和SAMEO-ATO分类在初级获得胆固醇瘤中复发性疾病的预测效用.
- 为了比较独特的内镜和组合的 tympanomastoid 方法之间的手术结果.
- 确定影响残留或复发胆固醇瘤的因素.
主要方法:
- 在2015年至2022年期间,从77名经历了耳手术的患者中,对81个耳朵进行了回顾性图表审查.
- 使用EAONO-JOS和SAMEO-ATO系统进行手术的分类.
- 多变量分析和卡普兰-梅尔生存分析,以评估疾病复发和手术方法的影响,随访时间中位数为36.7个月.
主要成果:
- 大多数病例是EAONO-JOS第二阶段 (65.4%) 和第三阶段 (21.0%).
- 在50.6%的病例中使用了独家内镜方法,总体残留病率为41.9%,复发率为7.4%.
- 无论是EAONO-JOS还是SAMEO-ATO分期预测残留或复发性疾病;然而,年龄较大与残留疾病风险较低相关,内镜方法降低了修复手术率.
结论:
- 虽然EAONO-JOS和SAMEO-ATO分类对于标准化数据收集是有用的,但无法预测初级获得胆固醇瘤的复发.
- 与组合方法相比,单独的内镜 tympanomastoid 手术似乎与更改手术的需求较低有关.
- 需要对更大的样本大小和更长的随访进行进一步的研究,以充分阐明这些分类和手术技术的作用.
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