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Audiometric assessment was performed pre- and postoperatively. The ChOLE classification was determined intraoperatively and via the preoperative CT scan. HRQoL was assessed pre- and postoperatively using the Zurich Chronic Middle Ear Inventory (ZCMEI-21).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 87 patients (mean age 45.2\u00a0years, SD 16.2) were included in this study. ChOLE stage I cholesteatoma was found in 8 (9%), stage II cholesteatoma was found in 65 (75%), and stage III cholesteatoma was found in 14 (16%) patients. Postoperatively, the mean air\u2013bone gap (0.5, 1, 2, 3\u00a0kHz) was significantly smaller than before surgery (14.3\u00a0dB vs. 23.0\u00a0dB; <jats:italic>p<\/jats:italic>\u2009=\u20090.0007). The mean ZCMEI-21 total score significantly decreased after surgery (26.8 vs. 20.7, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). No correlation between the ZCMEI-21 total score and both the ChOLE stage and the extent of the cholesteatoma (ChOLE subdivision \u201cCh\u201d) was found. A trend towards worse HRQoL associated with a poorer status of the ossicular chain (ChOLE subdivision \u201cO\u201d) was observed. The audiometric outcomes were not\u00a0associated with the extent of the cholesteatoma. The ChOLE subdivision describing the ossicular status showed a strong association with the pre- and postoperative air conduction (AC) thresholds. Further, the ZCMEI-21 total score and its hearing subscore correlated with the AC thresholds.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The ChOLE classification does not show a clear association with HRQoL measured by the ZCMEI-21. The HRQoL neither seems to be associated with the extent of the disease nor with the ossicular chain status. Yet, surgical therapy significantly improved HRQoL by means of reduced ZCMEI-21 total scores, which were strongly associated with the AC thresholds. Intraoperative assessment of a cholesteatoma using the ChOLE classification and HRQoL complement each other and provide useful information.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00405-020-06002-x","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T18:02:53Z","timestamp":1588701773000},"page":"2729-2738","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Mapping the ChOLE classification to hearing outcomes and disease-specific health-related quality of life"],"prefix":"10.1007","volume":"277","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0645-3591","authenticated-orcid":false,"given":"Nora M.","family":"Weiss","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"B\u00e4chinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Rrahmani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans E.","family":"Bernd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Huber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Mlynski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christof","family":"R\u00f6\u00f6sli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,5,5]]},"reference":[{"issue":"9","key":"6002_CR1","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1001\/archoto.2012.1800","volume":"138","author":"SY Choi","year":"2012","unstructured":"Choi SY, Cho Y-SS, Lee NJ, Lee J, Chung W-HH, Hong SH (2012) Factors associated with quality of life after ear surgery in patients with chronic otitis media. 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