{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:31:25Z","timestamp":1791973885235,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:00:00Z","timestamp":1733270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify factors associated with cholesteatoma in a large UK cohort. Although some risk factors are frequently reported (male sex, history of chronic otitis media), other associations require further evidence (deprivation, smoking).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and Setting<\/jats:title>\n                    <jats:p>Briefly, 1140 cholesteatoma cases from UK BioBank were compared to 4551 non\u2010cholesteatoma middle ear disease and 493\u2009832 ear disease\u2010free 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\u201010 codes are also calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cholesteatoma was significantly associated with sex (Adjusted odds ratio (AOR) for males\u2009=\u20091.33, 95%CI\u2009=\u2009[1.179\u20131.491]), age (AOR\u2009=\u20091.02, 95%CI\u2009=\u2009[1.011\u20131.026]) and deprivation (AOR\u2009=\u20091.08, 95%CI\u2009=\u2009[1.059\u20131.097]) compared to ear disease\u2010free controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Age and deprivation distributions for cholesteatoma and non\u2010cholesteatoma ear disease were similar. Although there was no significant association with smoking status, cholesteatoma was significantly associated with the ICD\u201010 code mental and behavioural disorders due to tobacco use (OR\u2009=\u20092.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, 95%CI\u2009=\u2009[1.942, 2.813]). 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study shows a large overlap between cholesteatoma and non\u2010cholesteatoma 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 associated factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.14257","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T04:53:46Z","timestamp":1733288026000},"page":"316-329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Epidemiology of Cholesteatoma in the\n                    <scp>UK<\/scp>\n                    Biobank"],"prefix":"10.1111","volume":"50","author":[{"given":"Emma","family":"Wilson","sequence":"first","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3792-9182","authenticated-orcid":false,"given":"Barbara Anne","family":"Jennings","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1801-1635","authenticated-orcid":false,"given":"Mizanur","family":"Khondoker","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-3236","authenticated-orcid":false,"given":"Carl M.","family":"Philpott","sequence":"additional","affiliation":[{"name":"ENT Department James Paget University Hospitals NHS Foundation Trust  Great Yarmouth Norfolk UK"},{"name":"Norwich and Norfolk University Hospital  Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Prinsley","sequence":"additional","affiliation":[{"name":"Norwich and Norfolk University Hospital  Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4753-9794","authenticated-orcid":false,"given":"Daniel S.","family":"Brewer","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"},{"name":"Earlham Institute, Norwich Research Park  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010003\u20100623\u2010x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489950180801"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13544"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2023.0048"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12900"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010014\u20103285\u2010y"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215110001878"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20256"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2010.07.001"},{"issue":"2","key":"e_1_2_12_11_1","first-page":"122","article-title":"Chronic Ear Disease Along the Coasts of Labrador and Northern Newfoundland","volume":"5","author":"Ratnesar P.","year":"1976","journal-title":"Journal of Otolaryngology"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/854024"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010018\u20100579\u2010z"},{"key":"e_1_2_12_14_1","volume-title":"Health and Deprivation: Inequality and the North","author":"Townsend P.","year":"1988"},{"key":"e_1_2_12_15_1","unstructured":"The MathWorks Inc \u201cMATLAB \u201d2022 https:\/\/www.mathworks.com."},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v042.i08"},{"key":"e_1_2_12_17_1","unstructured":"R Core Team \u201cR: A Language and Environment for Statistical Computing \u201d2022 https:\/\/www.R\u2010project.or."},{"issue":"10","key":"e_1_2_12_18_1","article-title":"Decreasing Incidence Rate for Surgically Treated Middle Ear Cholesteatoma in Denmark 1977\u20132007","volume":"57","author":"Djurhuus B. 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