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Peer-reviewedCC BY 4.0The Journal of Laryngology and Otology

Evaluating long-term recurrence of cholesteatoma following primary surgery: an umbrella review of surgical techniques and patient factors

  • Edi Handoko1
  • Rizki Ekaputra Handoko1
  • Ahmad Dian Wahyudi1
  1. 1Otorhinolaryngology-Head and Neck Surgery, Universitas Brawijaya, Indonesia
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Abstract

Objectives: This study aimed to synthesise existing systematic reviews to determine the true long-term recurrence rate of cholesteatoma following primary surgery and to evaluate the comparative effectiveness of surgical approaches (canal wall up vs canal wall down ) and adjunctive procedures on disease recidivism.

Methods: A systematic search of PubMed, Scopus and OpenAlex identified 23 studies (predominantly systematic reviews and meta-analyses) encompassing 12,819 patients with an equal to or greater than 12 months’ follow-up and clearly defined recurrence, evaluating canal wall up, canal wall down, mastoid obliteration and endoscopic assistance.

Results: Recurrence increased from 7 per cent at 12 months to 39 per cent at 15 years. Canal wall down showed lower recurrence than canal wall up. Mastoid obliteration (odds ratio, 0.33–0.45) and endoscopic techniques (risk ratio, 0.48–0.68) reduced recidivism and residual disease. Age and staged surgery increased risk, whereas planned second-look surgery was protective.

Conclusion: Cholesteatoma recurrence is strongly time-dependent. Combining appropriate surgical techniques with mastoid obliteration, endoscopic assistance and long-term surveillance improves long-term disease control.

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Cite

BibTeXRIS
BibTeX
@article{handoko2026evaluating,
  title = {{Evaluating long-term recurrence of cholesteatoma following primary surgery: an umbrella review of surgical techniques and patient factors}},
  author = {Edi Handoko and Rizki Ekaputra Handoko and Ahmad Dian Wahyudi},
  journal = {The Journal of Laryngology and Otology},
  year = {2026},
  month = nov,
  doi = {10.1017/s0022215126105234},
  url = {https://doi.org/10.1017/s0022215126105234},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Evaluating long-term recurrence of cholesteatoma following primary surgery: an umbrella review of surgical techniques and patient factors
AU  - Edi Handoko
AU  - Rizki Ekaputra Handoko
AU  - Ahmad Dian Wahyudi
PY  - 2026
DA  - 2026/11/06
JO  - The Journal of Laryngology and Otology
DO  - 10.1017/s0022215126105234
UR  - https://doi.org/10.1017/s0022215126105234
AB  - Objectives: This study aimed to synthesise existing systematic reviews to determine the true long-term recurrence rate of cholesteatoma following primary surgery and to evaluate the comparative effectiveness of surgical approaches (canal wall up vs canal wall down ) and adjunctive procedures on disease recidivism.  Methods: A systematic search of PubMed, Scopus and OpenAlex identified 23 studies (predominantly systematic reviews and meta-analyses) encompassing 12,819 patients with an equal to or greater than 12 months’ follow-up and clearly defined recurrence, evaluating canal wall up, canal wall down, mastoid obliteration and endoscopic assistance.  Results: Recurrence increased from 7 per cent at 12 months to 39 per cent at 15 years. Canal wall down showed lower recurrence than canal wall up. Mastoid obliteration (odds ratio, 0.33–0.45) and endoscopic techniques (risk ratio, 0.48–0.68) reduced recidivism and residual disease. Age and staged surgery increased risk, whereas planned second-look surgery was protective.  Conclusion: Cholesteatoma recurrence is strongly time-dependent. Combining appropriate surgical techniques with mastoid obliteration, endoscopic assistance and long-term surveillance improves long-term disease control.
SN  - 0022-2151
SN  - 1748-5460
ER  -