Abstract
Patients with the pars flaccida cholesteatoma and the pars tensa cholesteatoma who underwent initial surgery in our institute were classified based on the Classification and Staging of Cholesteatoma proposed by the Japan Otological Society in 2010.
Between 1999 and 2009, 236 cases of the pars flaccida cholesteatoma and 60 cases of the pars tensa cholesteatoma were undergone surgery in Niigata University. Average age at the surgery was 43.5 years in the flaccida type and 50 years in the tensa type respectively.
Cholesteatoma epithelium of the flaccida type tended to extend from the attic to antrum and mastoid cavity. On the other hand, in the case of the tensa type, cholesteatoma epithelium often progressed to the site of multiple variants on the attic, antrum and protympanium from the mesotympanium. In cases of the tensa cholesteatoma, the rate of facial nerve palsy and labyrinthine fistula merger was higher than the flaccida type, and disappearance rate of stapes superstructure was also higher. Mastoid cell development was poor in both cases and the cases of growth retardation had increased as the stage was raised. There may be a relationship between the regulation of mastoid development and the disease activity of cholesteatoma. The age at the time of surgery was high and the growth of mastoid air cells was extremely poor in the tensa type. So it was considered that the tensa type took a long time to establishment of cholesteatoma compared to the flaccida type.
