Cholesteatoma Growth Patterns: Are There Audiometric Differences between Posterior Epitympanics and Mesotympanics?

Abstract

Objectives:

Verify if there are differences in hearing impairment between posterior epitympanic and posterior mesotympanic cholesteatomas.

Methods:

This cross-sectional study evaluated 278 ears with cholesteatoma and no previous surgery between August 2000 and January 2013. Otoendoscopy and pure tone audiometry were performed at the first evaluation. The video-otoscopys were later analyzed and classified between the two main possible routes involved in cholesteatoma formation (posterior epitympanic and posterior mesotympanic). To compare the audiometric thresholds, we employed the Student t test.

Results:

The mean age was 33.7 years old, and 51.1% were male. The posterior epitympanic cholesteatoma was found in 51.4%. There were no differences in air and bone conduction thresholds between the two groups (P > 0.05). When the air-bone gaps were compared, however, the posterior mesotympanics had greater thresholds in 500 Hz, 2000Hz, and tritonal mean (P = 0.003, P = 0.03, and P = 0.02, respectively)

Conclusions:

The posterior mesotympanic cholesteatomas had greater air-bone gap thresholds in the speech frequencies when compared with posterior epitympanic cholesteatomas. However, the two growth patterns were very similar in the other audiometric parameters.