Abstract
Objective: Acquired cholesteatoma has been extensively studied. Theories that involve previous tympanic membrane retractions in its pathogenesis are the most accepted. However we do not know what happened in the contralateral ear. Our objective is to evaluate the prevalence of significant alterations in the contralateral ear of patients with acquired cholesteatoma.
Method: This is a transversal study. We evaluated 1015 patients with chronic otitis media in at least one ear and no previous surgery between August 2000 and January 2011. Otoendoscopy was carried out and recorded on the affected ear just as in the contralateral, which was classified as normal or abnormal.
Results: Two hundred and sixty patients with chronic otitis media with cholesteatoma were included. The mean age was 31.7 years, and 52.7% were male. Only 35.6% of the contralateral ears were normal or had minimal alterations, such as tympanosclerosis, neotympanum, and mild tympanic membrane retraction. The most prevalent alterations were moderate and severe tympanic membrane retractions (42%), followed by cholesteatoma (17%).
Conclusion: The results suggest that patients with acquired cholesteatoma have a greater probability of having some abnormality in the contralateral ear. The most common were eardrum retractions and cholesteatoma. This corroborates the idea that COM is not only an isolated event but a constitutional process with a high prevalence of bilaterality.
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