Is Cholesteatoma a Risk Factor for Graft Success Rate in Chronic Otitis Media Surgery?

Introduction: In developing countries, chronic otitis media (COM) and cholesteatoma are relatively prevalent.  Within the field of otology, COM surgery remains one of the most common surgical treatments. Most recent studies evaluating the potential prognostic factors in COM surgery have addressed graft success rate and types of middle ear and mastoid pathology. There has been much controversy about this issue until the present time. This study evaluated the effect of cholesteatoma on the GSR in COM surgery.   Materials and Methods: The present retrospective, study-controlled study investigated 422 ears undergoing COM surgery. The minimum and maximum postoperative follow-up periods were 6 and 48 months, respectively. The study group consisted of patients with cholesteatomatous COM, while the control group included patients with non-cholesteatomatous COM, who had undergone ear surgery.  Postoperative graft success rate and audiological test results were recorded and the effect of cholesteatoma on graft success rate was investigated.  Results: The overall GSR was 92.4%. In the study group (COM with cholesteatoma),the postoperative GSR, mean speech reception threshold improvement, and mean air-bone gap gain were 95.3%, 2.1 dB, and 3.2 dB, respectively. In the control group (COM without cholesteatoma), however, these measurements were 90.9%, 9.4 dB, and 9.1 dB, respectively. The difference between the two groups was not statistically significant.  Conclusion:  The study results suggest that cholesteatoma is not a significant prognostic factor in graft success rate.