Hearing loss assessment in primary and secondary acquired cholesteatoma,

ABSTRACT INTRODUCTION: Acquired middle ear cholesteatoma can be classified as primary or secondary. Although both can result in hearing loss, it is still controversial whether there is an association between the type of cholesteatoma and the degree of hearing loss. OBJECTIVE: To analyze the association between hearing loss and the type of acquired cholesteatoma, and the status of the ossicular chain. METHODS: This was a cross-sectional historical cohort study involving patients diagnosed with acquired cholesteatoma who were surgically treated. Air and bone conduction thresholds, air-bone gaps and the status of the ossicular chain were analyzed for both types of cholesteatoma. RESULTS: Eighty patients aged 5-57 were included in the study. Fifty-one patients had primary cholesteatoma and 29 had secondary cholesteatoma. Both types of cholesteatoma determined greater air-bone gaps at 0.5 kHz. Secondary cholesteatoma determined greater hearing loss in all analyzed frequencies and higher air conduction and air-bone gap means. CONCLUSION: There was association between hearing loss and the type of cholesteatoma. Secondary cholesteatoma resulted in greater hearing impairment.

引言与背景：获得性中耳胆脂瘤（acquired middle ear cholesteatoma）可分为原发性胆脂瘤（primary cholesteatoma）与继发性胆脂瘤（secondary cholesteatoma）两类。尽管二者均可引发听力损失，但胆脂瘤分型与听力损失程度间是否存在关联，目前仍存在争议。
研究目的：分析获得性中耳胆脂瘤分型与听力损失及听骨链（ossicular chain）状态之间的关联。
研究方法：本研究为横断面回顾性队列研究，纳入经手术治疗的获得性中耳胆脂瘤确诊患者。对两类胆脂瘤患者的气导阈值（air conduction thresholds）、骨导阈值（bone conduction thresholds）、气骨差（air-bone gaps）及听骨链状态进行分析。
研究结果：本研究共纳入80例年龄5~57岁的患者，其中51例为原发性胆脂瘤，29例为继发性胆脂瘤。两类胆脂瘤均与0.5kHz频率下更大的气骨差相关。继发性胆脂瘤患者在所有分析频率下的听力损失程度更严重，气导均值及气骨差均值更高。
研究结论：听力损失与胆脂瘤分型存在显著关联，继发性胆脂瘤会导致更严重的听力损伤。