Middle ear cholesteatoma treated with a mastoidectomy: a systematic review of the measures used

Abstract

Objectives: The inconsistent measures used to report outcomes after mastoidectomy to treat cholesteatoma make it impossible for clinicians to compare results and apply them appropriately to patient care. We sought to identify and assess the type and relative frequency of the reported measures.

Data sources: PubMed, EMBASE, the Web of Science.

Review methods: We searched 3 independent databases for articles that reported outcomes of middle ear cholesteatoma treated with mastoidectomy. Articles were assessed for eligibility using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and data were extracted by 2 independent investigators. Observational studies and randomized controlled trials from the past 30 years were included. Articles with less than 50 subjects and nonsurgical studies were excluded. The measures used by each study were recorded, and the relative frequency of each measure was calculated.

Results: Forty-three of 380 articles met criteria. Time to follow up was inconsistent. Most articles reported on preoperative qualitative parameters (77%); however, few reported on the severity of disease (19%) or formally staged the disease (12%). Not all studies reported on the presence of recurrent or residual disease (88%) or the postoperative audiogram results (70%). Only 12% presented results as a Kaplan-Meier disease-free curve. Most studies reported on complications (70%).

Conclusion: Reported measures were inconsistent among the studies, which makes comparisons between studies unreliable. Standardization will optimize future reporting and will allow for the establishment of best practices.

Keywords: cholesteatoma; mastoidectomy; measures; outcomes.