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Abstract：
Background/Objectives: Cholesteatoma presents significant management challenges in otolaryngology. This study aimed to delineate the influence of demographic and clinical characteristics, preoperative imaging, and surgical approaches on treatment success in cholesteatoma management. Methods: A cross-sectional analytical study was conducted at the Otolaryngology Department of the University Hospital from January 2021 to December 2022. It included 68 patients diagnosed with cholesteatoma, focusing on three objectives: assessing the impact of demographic and clinical characteristics on treatment outcomes, evaluating the predictive value of preoperative imaging findings, and analyzing the influence of surgical factors. Results: The study population predominantly consisted of male (56%) and Saudi (81%) patients, with an average age of 45 years. Logistic regression revealed that older age (OR: 1.05), male gender (OR: 0.63), and non-Saudi Arab ethnicity (OR: 2.14) significantly impacted treatment outcomes. Clinical characteristics such as severe disease severity (OR: 3.00) and longer symptom duration (OR: 0.96) also influenced treatment success. In preoperative imaging, labyrinthine fistula (Regression Coefficient: 0.63) and epidural extension (Coefficient: 0.55) emerged as key predictors. The surgical factors that significantly affected the outcomes included the extent of surgery (Complete Removal OR: 3.32) and the use of endoscopic approaches (OR: 1.42). Conclusions: This study highlights that patient demographics, clinical profiles, specific preoperative imaging features, and surgical strategies multifactorially determine cholesteatoma treatment success. These findings suggest the necessity for a tailored approach in cholesteatoma management, reinforcing the importance of individualized treatment plans based on comprehensive preoperative assessments.
摘要：
背景/目标：胆脂瘤在耳鼻咽喉科中提出了重大的治疗挑战。这项研究旨在描述人口统计学和临床特征的影响，术前成像,和手术方法对胆脂瘤治疗的成功。方法：2021年1月至2022年12月在大学医院耳鼻喉科进行了横断面分析研究。它包括68例诊断为胆脂瘤的患者，重点关注三个目标：评估人口统计学和临床特征对治疗结果的影响，评估术前影像学检查结果的预测价值，并分析了手术因素的影响。结果：研究人群主要由男性（56%）和沙特（81%）患者组成，平均年龄为45岁。Logistic回归显示年龄较大（OR：1.05），男性（OR：0.63），和非沙特阿拉伯种族（OR：2.14）显着影响治疗结果。诸如严重疾病严重程度(OR:3.00)和较长症状持续时间(OR:0.96)的临床特征也影响治疗成功。在术前成像中,迷路瘘（回归系数：0.63）和硬膜外延伸（系数：0.55）是关键预测因子。显著影响结果的手术因素包括手术程度(完全切除OR:3.32)和内窥镜入路的使用(OR:1.42)。结论：这项研究强调了患者的人口统计学，临床资料,特定的术前影像学特征，和多因素的手术策略决定了胆脂瘤治疗的成功。这些发现表明，在胆脂瘤管理中需要一种量身定制的方法，加强基于综合术前评估的个体化治疗计划的重要性。
