(Open access funding provided by Semmelweis University)
Szakterületek:
Klinikai orvostan
To investigate the rate of residual disease in the Potsic staging system for congenital
cholesteatomas.A protocol registration was published on PROSPERO (CRD42022383932),
describing residual disease as a primary outcome and hearing improvement as secondary.
A systematic search was performed in four databases (PubMed, Embase, Cochrane Library,
Web of Science) on December 14, 2022. Articles were included if cholesteatomas were
staged according to the Potsic system and follow-up duration was documented. Risk
of bias was evaluated using the Quality In Prognosis Studies (QUIPS) tool. In the
statistical synthesis a random effects model was used. Between-study heterogeneity
was assessed using I2.Thirteen articles were found to be eligible for systematic review
and seven were included in the meta-analysis section. All records were retrospective
cohort studies with high risk of bias. Regarding the proportions of residual disease,
analysis using the χ2 test showed no statistically significant difference between
Potsic stages after a follow-up of minimum one year (stage I 0.06 (confidence interval
(CI) 0.01-0.33); stage II 0.20 (CI 0.09-0.38); stage III 0.06 (CI 0.00-0.61); stage
IV: 0.17 (CI 0.01-0.81)). Postoperative and preoperative hearing outcomes could not
be analyzed due to varied reporting. Results on cholesteatoma location and mean age
at staging were consistent with those previously published.No statistically significant
difference was found in the proportions of residual disease between Potsic stages,
thus the staging system's applicability for outcome prediction could not be proven
based on the available data. Targeted studies are needed for a higher level of evidence.
