Correlative Factors Analysis Of Clinical Features, Resection Degree And Postoperative Complications Of Cranial Base Cholesteatoma

Objective: To investigate the clinical characteristics of cranial base cholesteatoma and the factors affecting the total resection rate and postoperative complication rate during the treatment.Methods: We retrospectively analyzed 68 patients with cranial base cholesteatoma treated by neurosurgery in the First Affiliated Hospital of China Medical University from October 2010 to October 2022.All cases were confirmed by preoperative imaging examination and postoperative pathology.Select the appropriate craniotomy approach according to the main site of the tumor and carry out the maximum resection of the tumor.Preoperative symptoms,tumor diameter,invasion degree to surrounding tissue,brain stem edema,invasion extent of skull base,surgical resection effect,complication rate,and symptom recovery before and after surgery were recorded.Clinical results Karnofsky functional status score was used to evaluate the quality of life.Univariate and multivariate analyses were performed on clinical features,surgical methods,tumor resection degree,postoperative complications and postoperative quality of life.Results: Among the 68 patients with cranial base cholesteatoma,31 of them underwent surgical resection with EAM technique,30 underwent total resection and 1 underwent majority resection.In 37 cases of simple microsurgical resection,28 cases were total resection,and 9 cases were majority resection.There have been no deaths.Postoperative KPS scores were improved in all patients.The patients were followed up for 3-139 months,and no tumor recurrence was observed.Postoperative complications mainly included fever in 3 cases,mild diplopia in 3 cases,postoperative infection in 3 cases,subcutaneous effusion in 3 cases,mild facial numbness in 2 cases,mild facial paralysis in1 case,and tinnitus in 1 case.Conclusion: Surgery methods,vascular wrapping are independent risk factors for surgical resection.Tumor volume,brainstem edema are independent risk factors for postoperative complications in patients with cranial base cholesteatomas.EAM technique has unique advantages in the treatment of cranial base cholesteatoma,which can increase the total surgical resection rate and reduce postoperative complications compared with pure microscope operation.