This project was funded through the Western Australian Safety and Quality of Surgical Care Project by an Australian National Health and Medical Research Council project grant.
Factors associated with developing cholesteatoma: A study of 45,980 children with middle ear disease†
Article first published online: 7 JAN 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 120, Issue 3, pages 625–630, March 2010
How to Cite
Spilsbury, K., Miller, I., Semmens, J. B. and Lannigan, F. J. (2010), Factors associated with developing cholesteatoma: A study of 45,980 children with middle ear disease. The Laryngoscope, 120: 625–630. doi: 10.1002/lary.20765
- Issue published online: 16 FEB 2010
- Article first published online: 7 JAN 2010
- Manuscript Accepted: 30 SEP 2010
- Manuscript Revised: 23 SEP 2010
- Manuscript Received: 25 AUG 2010
- Ventilation tubes;
- survival analysis;
- medical record linkage
To identify factors associated with the rate of developing cholesteatoma following ventilation tube insertion (VTI).
A population-based retrospective cohort study.
Administrative health data from all private and public hospitals in Western Australia for children who had at least one VTI from 1980 to 2004 was used to identify subsequent hospital admissions for cholesteatoma. Main outcome measures were time to cholesteatoma (survival) outcomes, including hazard ratios, log-rank tests, and Kaplan-Meier failure functions.
There were 45,980 children who underwent at least one VTI from 1980 to 2004 with 460 subsequently developing cholesteatoma. The cumulative percentage of children who developed cholesteatoma within 15 years after one VTI procedure was 0.9% (95% confidence interval [CI], 0.8–1.0), after two VTIs 2.1% (95% CI, 1.6–2.3), after three VTIs 3.8% (95% CI, 2.9–4.8), and after four or more VTIs 5.2% (95% CI, 4.0–6.7). The rate of developing cholesteatoma increased 10% (95% CI, 6–14) for each additional year in age before first VTI. For children who underwent two or more VTIs, the rate of cholesteatoma increased 21% (95% CI, 12–32) with each additional year between VTIs. Adenoid removal was associated with a 27% (95% CI, 11–40) reduction in the rate of developing cholesteatoma.
Children with persistent or refractory middle ear disease who required multiple VTIs were at increased risk of cholesteatoma. First ventilation tubes inserted at an early age, subsequent ventilation tubes inserted without delay, and adenoid removal were associated with a reduced rate of cholesteatoma development. Laryngoscope, 2010