Risk of Acquired Cholesteatoma and External Auditory Canal Stenosis in Traumatic Brain Injury: A Nationwide Population-Based Cohort Study

Hung-Che Lin, Cheng-Ping Shih, Hsin-Chien Chen, Chun-An Cheng, Yuahn-Sieh Huang, Chen-Shien Lin, Chi-Hsian Chung, Bor-Rong Huang, Jih-Chin Lee, Wei-Chuan Shangkuan, Wu-Chien Chien and Chi-Ming Chu
Additional contact information
Hung-Che Lin: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan
Cheng-Ping Shih: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan
Hsin-Chien Chen: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
Chun-An Cheng: Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
Yuahn-Sieh Huang: Department of Biology and Anatomy, National Defense Medical Center, Taipei 11490, Taiwan
Chen-Shien Lin: Chinese Medicine Department, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
Chi-Hsian Chung: School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
Bor-Rong Huang: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
Jih-Chin Lee: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
Wei-Chuan Shangkuan: Department of Otolaryngology-Head and Neck Surgery, Taipei City Hospital, Taipei City Government, Taipei 11146, Taiwan
Wu-Chien Chien: School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
Chi-Ming Chu: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan

IJERPH, 2020, vol. 17, issue 18, 1-12

Abstract: The aim of study is to investigate the risk of developing acquired cholesteatoma and external auditory canal (EAC) stenosis after traumatic brain injury (TBI) from the Taiwan National Health Insurance Research Database (NHIRD). Each subject was individually traced from their index date to identify those who received a diagnosis of acquired cholesteatoma and EAC stenosis. Cox regression analyses were applied to determine the risk of TBI-related acquired cholesteatoma and EAC stenosis. The follow-up data collected over 10 years were obtained from the TBI and comparison cohorts, of 455,834 and 911,668 patients, respectively. Multivariate analysis demonstrated that TBI significantly increased the risk of cholesteatoma (adjusted hazard ratio (HR), 1.777; 95% confidence interval (CI), 1.494−2.114, p < 0.001) and EAC stenosis (adjusted (HR), 3.549; 95% (CI), 2.713−4.644, p < 0.001). In our subgroup injury analysis, falls had the highest associated risk (4.308 times), followed by traffic injuries (66.73%; 3.718 times that of the control group). Otolaryngologists should not neglect the clinical importance and carefully investigate the possibility of subsequent cholesteatoma and EAC stenosis, which leads to hearing impairment in patients with TBI. Our research also shows the important role in preventing TBI, especially as a result of traffic injuries and falls.

Keywords: traumatic brain injury; acquired cholesteatoma; external auditory canal stenosis; National Health Insurance Research Database (NHIRD) (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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