Chronic rhinosinusitis could increase the risk of cholesteatoma of middle ear

BACKGROUND Chronic rhinosinusitis (CRS) is an inflammatory disease of the sinonasal mucosa. Inflammation of the sinonasal mucosa often can cause obstruction of the eustachian tube, with subsequent impairment of pressure regulation in the middle ear. However, it still remains unclear whether CRS can cause cholesteatoma of middle ear during a lifetime. Therefore, we identify the association of CRS with risk for cholesteatoma of middle ear. METHODS We used a nationwide cohort sample of data, representing approximately 1 million patients to investigate the prospective association between CRS and cholesteatoma of middle ear. A total of 18,140 CRS patients and 36,280 patients without CRS (comparison group) were enrolled after 1: 2 propensity score matching. Cox proportional hazards regression models with log-rank test were used to identify the incidence and hazard ratio (HR). RESULTS The incidence of cholesteatoma of middle ear was 2.5910 per 1000 person-years in the CRS group and 1.3506 per 1000 person-years in the comparison group. The adjusted HR for patients with CRS developing cholesteatoma of middle ear during the follow-up period was 1.6493 (95% confidence interval [CI], 1.0893 - 2.4973) after other covariates. Additionally, the adjusted HRs of developing cholesteatoma of middle ear were greater in patients with CRS without nasal polyp (adjusted HR = 1.5689, 95% CI, 1.0268 - 2.3973) than in those with CRS with nasal polyp (adjusted HR = 3.6765, 95% CI, 1.3138 - 10.2883). CONCLUSIONS This long-term observational study suggests that CRS is associated with an increased incidence of cholesteatoma of middle ear. This article is protected by copyright. All rights reserved.