Surgery in Cholesteatoma: Ten years Follow-up 1

Abstract

Dear Editor, I was greatly interested in the article "Surgery in cholesteatoma: Ten years Follow-up" by Dr. M. Ajalloueyan published in your journal in March 2006; Vol 31, No 1: 37-40.I think there are grave misconceptions and many doubts about this article. That article has some misleading data that should be clarified by the author. The descriptions of table 1, "Statistical characteristics of patients" are not clear. In column 5 of the same table, the total number of patients with otorrhea was mentioned to be 5+26=91!The article mentioned that the age range of patients was 15-73 years, but table 1 shows 16-81 years. The author claimed that "the incidence of cholesteatoma was significantly high in men" although he has not specify how high!The author affirmed "intact tympanic membrane was seen in 86 patients which was reported in 67 patients of CWD and 21 patients of CWU group.” Again, there is clearly an error because 67+21 equals 88, and not 86.There has been a strange ambiguity about the hearing of the patients after surgery. The author has listed a few numbers (dB), but it is not clear whether the numbers (dB) were hearing level as mentioned in text and title of table 2, or hearing loss. These examples show a significant discrepancy between the text, title of table, and footnote of the table!Otorrhea has remained the most common presentation in all age groups of CWD cases in some studies.1 In table 1, column 5, no subject in CWD group had otorrhea! This is very doubtful! It is hardly surprising that the author jumped to the wrong conclusion in stating that "the ideal treatment for cholesteatoma is a one – stage procedure which can completely eradicate the disease and avoid the recurrence". Why he used Silastic sheet? The readers must pay attention to what an eminent otologist would do about cholesteatoma surgery. In cholesteatoma cases they stage 70% or more of the cases because of both mucosal disease problems and the certainty (or uncertainty) of removal of cholesteatoma.2 In abstract and in the last paragraph of the Discussion, what the author has said about endoscope and computed tomography were irrelevant to the propose of the study. He suddenly report about endoscope without describing it in Methods, or report its benefit in the Results section.