Abstract
Level of Evidence: 3 Objective(s) To identify the risk
factors for Cholesteatoma in a large UK cohort. Although some risk
factors are well established (male sex, history of chronic otitis
media), others require further evidence (deprivation, smoking).
Design and Setting 1,140 cholesteatoma cases from UK BioBank
were compared to 4,551 non-cholesteatoma middle ear disease and 493,832
ear disease-free controls. Adjusted odds ratios were calculated for
demographic factors including age, sex, ethnicity, deprivation and
smoking status with logistic regressions. Odds ratios for overlapping
ICD-10 codes are also calculated. Results Cholesteatoma was
significantly associated with sex (Adjusted odds ratio (AOR) for
males=1.33), age (AOR=1.02) and deprivation (AOR=1.08) compared to ear
disease-free controls ( p<0.001). Age and deprivation
distributions for cholesteatoma and non-cholesteatoma ear disease were
similar. Although there was no significant association with smoking
status, cholesteatoma was significantly associated with the ICD-10 code
mental and behavioural disorders due to tobacco use (OR=2.34,
p<0.001). Cholesteatoma was also strongly associated with
a wide range of inflammatory middle ear conditions and chronic sinus
inflammation, suggesting an increased susceptibility to inflammation of
the upper airways. Conclusion This study shows a large overlap
between cholesteatoma and non-cholesteatoma ear disease in terms of
numbers and demographics, with sex being a key factor distinguishing
between the two, suggesting that there are both common and distinct risk
factors exist.