AB244. SOH25_AB_156. The burden of cholesteatoma in otology

Background: Otology encompasses pathology related to the outer, middle, and inner ears. Conversion to surgical intervention is not as frequent as for other subspecialties within otolaryngology. The primary role of otology surgery is either ablative surgery for cholesteatoma or reconstructive surgery for improved hearing. We analyse the burden of cholesteatoma surgery on an otology practice, which is the most prolonged and time-consuming surgical intervention pertaining to otology.

Methods: A retrospective audit was carried out of all otology cases in a single unit over a 12-year period, categorised into ablative versus reconstructive cases. We audit the remainder, inclusive of ventilation of the middle ear, excision of malignant and benign pathology of the outer ear pinna, and pathology relevant to the inner ear and assess the impact of cholesteatoma on our service.

Results: A total of 880 otology surgeries were carried out by a single surgeon over a 12-year period. Among them, 128 cases were classified as ablative, pertaining to cholesteatoma surgery, accounting for 14.5% of all cases. The majority of otology cases in our unit addressed the middle ear for ventilatory purposes and repair of tympanic membrane perforations with or without ossicular reconstruction with 16% of cases, related to ablation of inner ear neuroepithelium for vestibular disorders.

Conclusions: Despite the burden of cholesteatoma pathology and its recognised recurrent rates, ablative surgery for cholesteatoma only accounted for 1/6 of the otology practice at our unit.

Keywords: Cholesteatoma; ear, nose & throat (ENT); mastoid; otology; surgery