A multivariate analysis of the factors predicting hearing outcome after surgery for cholesteatoma in children
| Autor: | A H Jardine, D Owens, A R Maw, N K Chadha, Philip Robinson, Stuart Gillett |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Mastoides Adolescent Mastoid Cohort Studies Hearing Humans Medicine Stage (cooking) Child Hearing Disorders Retrospective Studies Cholesteatoma Middle Ear biology business.industry Cholesteatoma Retrospective cohort study General Medicine biology.organism_classification medicine.disease Confidence interval Surgery Treatment Outcome England Otorhinolaryngology El Niño Child Preschool Multivariate Analysis Cohort Female Otologic Surgical Procedures business |
| Zdroj: | The Journal of Laryngology & Otology. 120:908-913 |
| ISSN: | 1748-5460 0022-2151 |
| DOI: | 10.1017/s0022215106002179 |
| Popis: | Objective: To explore factors influencing hearing outcomes in children treated by canal wall up (CWU) and canal wall down (CWD) mastoid surgery.Methods: Retrospective cohort study including three units in Bristol and Bath, UK. Ninety consecutive children underwent cholesteatoma mastoid surgery, with the first procedure between 1998 and 2001; minimum follow up was three disease-free years.Results: The CWU and CWD cohorts significantly differed in pre-operative stage and hearing. After disease eradication, air conduction (AC) thresholds changed by +4.0 dB (95 per cent confidence intervals (95%CI) −2.0, 10.1) in the CWD group and −5.3 dB (95%CI −9.3, 1.3) in the CWU group (p=0.029). Using multiple linear regression to account for cohort differences, AC thresholds were increased by: pre-operative AC threshold (pp=0.013), and CWD-surgery (p=0.005).Conclusion: Disease-free hearing was better with CWU-surgery, less initial ossicular damage, and better pre-operative hearing. Worse initial disease increased the likelihood of CWD surgery. Wider use of ossiculoplasty in the CWU cohort (51 per cent vs 5 per cent) may partially explain the superior results. |
| Databáze: | OpenAIRE |
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