Postoperative Patient Reported Outcomes After Cholesteatoma Surgery

Abstract

Background: Results and success measures of cholesteatoma surgery are generally described using objective data whereas subjective data are mostly lacking. Patients experiences and complaints are becoming more important alongside clinical and audiometric outcome measures in cholesteatoma care. Objective: To investigate the course of patient-reported complaints, the impact of complaints, audiometric measures and the stability of audiometric measures, and complaints over time after primary and recurrent/residual cholesteatoma surgery. Methods: Postoperative patients were prospectively included and divided into primary acquired and recurrent/residual cholesteatoma. The EuroQol 5D (EQ-5D-3L), Otology Questionnaire Amsterdam (OQUA), and the Speech Spatial Questionnaire (SSQ) were completed by 144 patients up to 2 years postoperative. Patient-reported complaints divided in eight separate domains, postoperative hearing and impact on daily life were longitudinally assessed by means of linear mixed models.Results: Hearing loss and tinnitus are the most reported postoperative complaints over time. Patient-reported loss of taste and the impact of all complaints decline over time. All other patient-reported complaints remain stable over time, only itch complaints fluctuate. Primary cholesteatoma patients score significantly higher on hearing loss complaints compared with recurrent/residual patients although they have comparable mean audiometric hearing loss. Furthermore, pure-tone hearing threshold, instead of asymmetric hearing loss, is correlated with the localization domain of the SSQ. Conclusion:This study provides important insights in the course of complaints and its impact on daily life after cholesteatoma surgery. Overall, the postoperative patientreported complaints after cholesteatoma surgery are generally low in the studied population.

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“…However, these procedures are sometimes required to remove a benign or malignant tumor or to place a cochlear implant. At least 1,200 procedures per annum are already performed in the Netherlands to remove cholesteatoma, a benign tumor, and to place a cochlear implant (1;2). These procedures require drilling in the temporal bone to create a pathway to the target, the tumor for removal, or the cochlea for implantation of electrodes, without damaging critical structures.…”