Practical applicability of the STAMCO and ChOLE classification in cholesteatoma care

DCD Consortium

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Abstract

BACKGROUND: To compare cholesteatoma care internationally and to evaluate outcomes, ear surgeons must use the same terminology. However, a clear universal definition on how to describe the extension, destruction and accompanying morbidity caused by the cholesteatoma is lacking. The practical applicability by means of interrater agreement is assessed for the STAMCO and the ChOLE classification. METHODS: A total of 134 adult patients derived from the nationwide multicentre study in the Netherlands, entitled Dutch Cholesteatoma Data (DCD) were included. Retrospective analysis of 134 surgical reports according to the STAMCO and ChOLE classification for localisation/extension of the cholesteatoma, complication status and ossicular chain status. Both the percentage agreement and the interrater agreement were determined for each item of the classifications and interrater agreement was compared between the classifications as a whole. RESULTS: Differences in interrater agreement were found for both the localisation/extension of the cholesteatoma and ossicular chain status. STAMCO classification derived from the surgical report scored better on the localisation/extension of the cholesteatoma, whereas the ChOLE classification derived from the surgical report scored better on the status of the ossicular chain. In both classifications, complication status had a low agreement level but was also poorly registered in the surgical reports. CONCLUSION: Both STAMCO and ChOLE will be beneficial in uniform registration of cholesteatoma pathology in practice. Modifications proposed for both classifications may make them even more practical applicable in the future. A common denominator obtained from these two classifications may be incorporated in a standardised surgical report to facilitate evaluation which make outcomes transferable towards both classifications.

Original languageEnglish
Pages (from-to)3777-3787
Number of pages11
JournalEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
Volume278
Issue number10
Early online date18 Dec 2020
DOIs
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
Fleur A. ten Tije, Sophia E. Kramer, Robert Jan Pauw & Paul Merkus were financially supported by The Netherlands Organisation for Health Research and Development (ZonMw) (grant 80-83700-98-16504), Zorgverzekeraars Nederland (ZN) and Stichting Het Heinsius-Houbolt foundation. For the remaining authors none were declared.

Funding Information:
We would like to thank Dr. B.I. Lissenberg-Witte (Epidemiology & Biostatistics department of Amsterdam UMC, Amsterdam, the Netherlands) for the statistical assistance in this study. List of study group members: The following were members of the original DCD Consortium study group: Heike J. Nyst MD, Department of Otolaryngology–Head and Neck Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam; (2) Lisa van der Putten MD PHD, Department of Otolaryngology–Head and Neck Surgery, Noordwest Ziekenhuisgroep, Alkmaar & Den Helder; (3) Annemarie P. Graveland MD PHD; Department of Otolaryngology–Head and Neck Surgery, Noordwest Ziekenhuisgroep, Alkmaar & Den Helder; (4) Gerben G. Kingma MD, Department of Otolaryngology–Head and Neck Surgery, Noordwest Ziekenhuisgroep, Alkmaar & Den Helder; (5) Jeroen W.L. van Lange MD, Department of Otolaryngology–Head and Neck Surgery, Noordwest Ziekenhuisgroep, Alkmaar & Den Helder; (6) Guido T.M. de Kuyper MD, Department of Otolaryngology–Head and Neck Surgery, Noordwest Ziekenhuisgroep, Alkmaar & Den Helder; (7) Johan M. Schmidt MD, Department of Otolaryngology–Head and Neck Surgery, Noordwest Ziekenhuisgroep, Alkmaar & Den Helder; (8) Jantine Venker MD, Department of Otolaryngology–Head and Neck Surgery, Noordwest Ziekenhuisgroep, Alkmaar & Den Helder; (9) Dick J. Warmerdam MD PHD, Department of Otolaryngology–Head and Neck Surgery, Noordwest Ziekenhuisgroep, Alkmaar & Den Helder; (10) Tjasse D. Bruintjes MD PHD, Department of Otolaryngology–Head and Neck Surgery, Gelre ziekenhuizen, Apeldoorn & Zutphen; (11) Raphael J.B. Hemler MD PHD, Department of Otolaryngology–Head and Neck Surgery, Gelre ziekenhuizen, Apeldoorn & Zutphen; (12) Kees J. Langenhuijsen MD, Department of Otolaryngology–Head and Neck Surgery, Gelre ziekenhuizen, Apeldoorn & Zutphen; (13) Stephanie M. Winters MD PHD, Department of Otolaryngology–Head and Neck Surgery, Gelre ziekenhuizen, Apeldoorn & Zutphen; (14) Jeroen Mud MD, Department of Otolaryngology–Head and Neck Surgery, Gelre ziekenhuizen, Apeldoorn & Zutphen; (15) Adriaan F. Holm MD PHD, Department of Otolaryngology–Head and Neck Surgery, Wilhelmina ziekenhuis, Assen; (16) Ferdinand A.W. Peek MD, Department of Otolaryngology–Head and Neck Surgery, Reinier de Graaf Groep, Delft; (17) Jan Pieter Koopman MD, Department of Otolaryngology–Head and Neck Surgery, Haga ziekenhuis, Den Haag; (18) Steven J.H. Bom MD PHD, Department of Otolaryngology–Head and Neck Surgery, Deventer Ziekenhuis, Deventer; (19) Henri-Jacques Tjong-Ayong MD, Department of Otolaryngology–Head and Neck Surgery, Nij Smellinghe Ziekenhuis, Drachten; (20) Jan Pieter de Mönnink MD, Department of Otolaryngology–Head and Neck Surgery, Sint-Anna Ziekenhuis, Geldrop; (21) Nynke Boelstra-van Cruijsen MD PHD; Department of Otolaryngology–Head and Neck Surgery, Martini ziekenhuis, Groningen; (22) Jurjan R. de Boer MD PHD, Department of Otolaryngology–Head and Neck Surgery, Martini ziekenhuis, Groningen; (23) Sietske F. Meinesz MD, Department of Otolaryngology–Head and Neck Surgery, Haags Medisch Centrum, Den Haag; (24) Josephina M. Kruyt MD, Department of Otolaryngology–Head and Neck Surgery, Haags Medisch Centrum, Den Haag; (25) David R. Colnot MD PHD, Department of Otolaryngology–Head and Neck Surgery, Diakonessenhuis, Utrecht; (26) Jasper J. Quak MD PHD, Department of Otolaryngology–Head and Neck Surgery, Diakonessenhuis, Utrecht; (27) Pepijn A. Borggreven MD PHD, Department of Otolaryngology–Head and Neck Surgery, Diakonessenhuis, Utrecht; (28) Rick van de Langenberg MD PHD, Department of Otolaryngology–Head and Neck Surgery, Diakonessenhuis, Utrecht; (29) Adriana J.G.E. Wedler-Peeters MD, Department of Otolaryngology–Head and Neck Surgery, Zuyderland MC, Sittard-Geleen & Heerlen; (30) Jorien Snel-Bongers MD PHD; Department of Otolaryngology–Head and Neck Surgery, Zuyderland MC, Sittard-Geleen & Heerlen; (31) Eelco E. Kummer MD, Department of Otolaryngology–Head and Neck Surgery, Zaans Medisch Centrum, Zaandam; (32) Annette J. ter Schiphorst MD, Department of Otolaryngology–Head and Neck Surgery, Isala ziekenhuis, Zwolle.

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© 2020, The Author(s).

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