{"id":"https://openalex.org/W4415946331","doi":"https://doi.org/10.1093/bjsopen/zraf131","title":"Long-term recurrence of cholesteatoma after surgery: pooled rates and determinants","display_name":"Long-term recurrence of cholesteatoma after surgery: pooled rates and determinants","publication_year":2025,"publication_date":"2025-09-13","ids":{"openalex":"https://openalex.org/W4415946331","doi":"https://doi.org/10.1093/bjsopen/zraf131","pmid":"https://pubmed.ncbi.nlm.nih.gov/41189490","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/12587149"},"language":"en","primary_location":{"id":"doi:10.1093/bjsopen/zraf131","doi":"https://doi.org/10.1093/bjsopen/zraf131","is_oa":true,"landing_page_url":"https://doi.org/10.1093/bjsopen/zraf131","pdf_url":null,"source":{"id":"https://openalex.org/S4210237822","display_name":"BJS Open","issn_l":"2474-9842","issn":["2474-9842"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-20","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BJS Open","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1093/bjsopen/zraf131","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5077805883","display_name":"Saqr Massoud","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801977241","display_name":"Rebecca Sieff Hospital","ror":"https://ror.org/05mw4gk09","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2801977241"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Saqr Massoud","raw_affiliation_strings":["Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","institution_ids":["https://openalex.org/I2801977241"]},{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel","institution_ids":["https://openalex.org/I2801977241"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5046387485","display_name":"Raed Farhat","orcid":"https://orcid.org/0000-0002-4250-6494","observed_orcids":["https://orcid.org/0000-0002-4250-6494"]},"institutions":[{"id":"https://openalex.org/I2801977241","display_name":"Rebecca Sieff Hospital","ror":"https://ror.org/05mw4gk09","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2801977241"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Raed Farhat","raw_affiliation_strings":["Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","institution_ids":["https://openalex.org/I2801977241"]},{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel","institution_ids":["https://openalex.org/I2801977241"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5094179573","display_name":"Uday Abd Elhadi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801977241","display_name":"Rebecca Sieff Hospital","ror":"https://ror.org/05mw4gk09","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2801977241"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Uday Abd Elhadi","raw_affiliation_strings":["Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","institution_ids":["https://openalex.org/I2801977241"]},{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel","institution_ids":["https://openalex.org/I2801977241"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120274582","display_name":"Bashir Abu Abed","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2802646120","display_name":"Barzilai Medical Center","ror":"https://ror.org/00hmeez77","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2802646120"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Bashir Abu Abed","raw_affiliation_strings":["Department of Internal Medicine, Brazilai Medical Center , Ashkelon ,","Department of Internal Medicine, Brazilai Medical Center, Ashkelon, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Brazilai Medical Center , Ashkelon ,","institution_ids":["https://openalex.org/I2802646120"]},{"raw_affiliation_string":"Department of Internal Medicine, Brazilai Medical Center, Ashkelon, Israel","institution_ids":["https://openalex.org/I2802646120"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5003512869","display_name":"Shlomo Merchavy","orcid":"https://orcid.org/0000-0002-0442-835X","observed_orcids":["https://orcid.org/0000-0002-0442-835X"]},"institutions":[{"id":"https://openalex.org/I2801977241","display_name":"Rebecca Sieff Hospital","ror":"https://ror.org/05mw4gk09","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2801977241"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Shlomo Merchavy","raw_affiliation_strings":["Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","institution_ids":["https://openalex.org/I2801977241"]},{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel","institution_ids":["https://openalex.org/I2801977241"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5001980114","display_name":"Alaa Safia","orcid":"https://orcid.org/0000-0002-9574-8729","observed_orcids":["https://orcid.org/0000-0002-9574-8729"]},"institutions":[{"id":"https://openalex.org/I2801977241","display_name":"Rebecca Sieff Hospital","ror":"https://ror.org/05mw4gk09","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2801977241"]}],"countries":["IL"],"is_corresponding":true,"raw_author_name":"Alaa Safia","raw_affiliation_strings":["Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel"],"raw_orcid":"https://orcid.org/0000-0002-9574-8729","affiliations":[{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center , Safed ,","institution_ids":["https://openalex.org/I2801977241"]},{"raw_affiliation_string":"Department of Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel","institution_ids":["https://openalex.org/I2801977241"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5001980114"],"corresponding_institution_ids":["https://openalex.org/I2801977241"],"apc_list":{"value":2185,"currency":"GBP","value_usd":2881},"apc_paid":{"value":2185,"currency":"GBP","value_usd":2881},"fwci":2.972,"has_fulltext":false,"cited_by_count":4,"citation_normalized_percentile":{"value":0.92650666,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":97,"max":98},"biblio":{"volume":"9","issue":"6","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10861","display_name":"Ear Surgery and Otitis Media","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2733","display_name":"Otorhinolaryngology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10861","display_name":"Ear Surgery and Otitis Media","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2733","display_name":"Otorhinolaryngology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14326","display_name":"Ear and Head Tumors","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12297","display_name":"Otolaryngology and Infectious Diseases","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cholesteatoma","display_name":"cholesteatoma","score":0.9829999804496765},{"id":"https://openalex.org/keywords/postoperative-recurrence","display_name":"postoperative recurrence","score":0.828000009059906},{"id":"https://openalex.org/keywords/middle-ear-disease","display_name":"middle ear disease","score":0.6949999928474426},{"id":"https://openalex.org/keywords/canal-wall-down-surgery","display_name":"canal wall down surgery","score":0.6959999799728394},{"id":"https://openalex.org/keywords/mastoid-obliteration","display_name":"mastoid obliteration","score":0.8259999752044678},{"id":"https://openalex.org/keywords/ossicular-reconstruction","display_name":"ossicular reconstruction","score":0.9850000143051147},{"id":"https://openalex.org/keywords/acquired-cholesteatoma","display_name":"acquired cholesteatoma","score":0.7770000100135803},{"id":"https://openalex.org/keywords/congenital-cholesteatoma","display_name":"congenital cholesteatoma","score":0.9629999995231628},{"id":"https://openalex.org/keywords/risk-factors","display_name":"risk factors","score":0.4699999988079071},{"id":"https://openalex.org/keywords/tympanoplasty","display_name":"tympanoplasty","score":0.6800000071525574},{"id":"https://openalex.org/keywords/tympanomastoidectomy","display_name":"tympanomastoidectomy","score":0.9610000252723694},{"id":"https://openalex.org/keywords/children-versus-adults","display_name":"children versus adults","score":0.6100000143051147},{"id":"https://openalex.org/keywords/reoperation","display_name":"reoperation","score":0.5920000076293945}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7950000166893005},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3889999985694885},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3564000129699707},{"id":"https://openalex.org/C2780725665","wikidata":"https://www.wikidata.org/wiki/Q558230","display_name":"Cholesteatoma","level":2,"score":0.32829999923706055},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.3077000081539154},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.3009999990463257},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.29319998621940613},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.28769999742507935},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.2680000066757202},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.2637999951839447}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1093/bjsopen/zraf131","doi":"https://doi.org/10.1093/bjsopen/zraf131","is_oa":true,"landing_page_url":"https://doi.org/10.1093/bjsopen/zraf131","pdf_url":null,"source":{"id":"https://openalex.org/S4210237822","display_name":"BJS Open","issn_l":"2474-9842","issn":["2474-9842"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-20","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BJS Open","raw_type":"journal-article"},{"id":"pmid:41189490","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41189490","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BJS open","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1093/bjsopen/zraf131","doi":"https://doi.org/10.1093/bjsopen/zraf131","is_oa":true,"landing_page_url":"https://doi.org/10.1093/bjsopen/zraf131","pdf_url":null,"source":{"id":"https://openalex.org/S4210237822","display_name":"BJS Open","issn_l":"2474-9842","issn":["2474-9842"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-20","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BJS Open","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Systematic Review","id":"https://openalex.org/study-designs/systematic-review"},{"display_name":"Meta-Analysis","id":"https://openalex.org/study-designs/meta-analysis"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":5,"referenced_works":["https://openalex.org/W2045309945","https://openalex.org/W2790533386","https://openalex.org/W4313379560","https://openalex.org/W4362639827","https://openalex.org/W4401315112"],"related_works":["https://openalex.org/W4415188451","https://openalex.org/W4210284837","https://openalex.org/W2013361309","https://openalex.org/W4405528872","https://openalex.org/W4391462478","https://openalex.org/W2995542644","https://openalex.org/W7165764092","https://openalex.org/W2132431314","https://openalex.org/W2594000046","https://openalex.org/W2757803340"],"abstract_inverted_index":{"Cholesteatoma":[0],"is":[1,716],"a":[2,48,261,473,545,579,618],"destructive":[3],"lesion":[4],"of":[5,37,88,133,198,205,211,265,400,500,522,526,555,567,583,712],"the":[6,66,184,242,252,282,290,302,317,331,441,489,498,729,735],"middle":[7],"ear":[8],"that,":[9],"despite":[10],"surgical":[11,27,45,148,249,403,413,416,482,584,631],"removal,":[12],"frequently":[13],"recurs1.":[14],"Reported":[15],"recurrence":[16,58,105,134,206,216,263,284,303,332,398,464,493,576,588,609],"rates":[17,228,399],"vary":[18],"widely":[19],"depending":[20],"on":[21,738],"patient":[22,485],"age,":[23,143,176,409],"disease":[24,359,471,616],"severity,":[25],"and":[26,44,64,81,91,100,117,147,197,312,345,383,415,455,469,484,530,565,605,614,623,633,694],"approach2.":[28],"Although":[29],"previous":[30],"systematic":[31],"reviews3,4":[32],"have":[33,40,638],"addressed":[34],"specific":[35],"aspects":[36],"recurrence,":[38],"none":[39],"comprehensively":[41],"evaluated":[42],"clinical":[43],"predictors":[46,167],"across":[47],"large":[49],"global":[50],"cohort.":[51],"A":[52],"meta-analysis":[53,132,427],"was":[54,76,113,136,151,181,218,251,279,532],"conducted":[55],"to":[56,164,224,305,319,347,444,595,629,641],"determine":[57],"rates,":[59],"identify":[60],"key":[61],"risk":[62,442],"factors,":[63],"explore":[65],"long-term":[67,447,501,599,625],"cumulative":[68],"incidence":[69],"rate":[70,217,264,304,318,333],"following":[71,402],"cholesteatoma":[72,145,237,401,410,437,590],"surgery.":[73],"This":[74,426],"review":[75],"registered":[77],"in":[78,106,229,432,492],"PROSPERO":[79],"(CRD42024550351)":[80],"followed":[82],"PRISMA":[83],"guidelines.":[84],"PubMed,":[85],"Scopus,":[86],"Web":[87],"Science,":[89],"CENTRAL,":[90],"Google":[92],"Scholar":[93],"were":[94,110,120,192,195,207,297,459,525,569],"searched":[95],"during":[96,728],"2000\u20132024.":[97],"Observational":[98],"studies":[99,188,524,535,550,626],"randomized":[101],"trials":[102],"reporting":[103],"postoperative":[104],"\u2265":[107],"20":[108],"patients":[109,434],"eligible.":[111],"Recidivism":[112],"excluded.":[114],"Data":[115],"extraction":[116],"study":[118,731],"selection":[119],"performed":[121,152],"independently":[122,394],"by":[123,129,406,504,553],"two":[124],"investigators,":[125],"with":[126,226,268,281,308,322,324,335,440,462,517,598,603],"disagreements":[127],"resolved":[128],"consensus.":[130],"Random-effects":[131],"proportions":[135],"carried":[137,472],"out.":[138],"Predefined":[139],"subgroup":[140],"analyses":[141],"included":[142,523],"stage,":[144,412],"type,":[146,411],"technique.":[149],"Meta-regression":[150],"using":[153,183],"Stata\u00ae":[154],"version":[155],"18":[156],"(StataCorp,":[157],"College":[158],"Station,":[159],"TX,":[160],"USA)":[161],"meta":[162],"command":[163],"examine":[165],"continuous":[166],"(for":[168],"example":[169],"percentage":[170],"undergoing":[171],"staged":[172,375,612],"or":[173,507],"revisional":[174],"surgery,":[175,439],"follow-up":[177,355,407],"duration).":[178],"Study":[179],"quality":[180,201,566],"assessed":[182,571],"Newcastle\u2013Ottawa":[185],"Scale.":[186],"Eighty-four":[187],"(12":[189,245],"819":[190],"patients)":[191],"included;":[193],"most":[194],"retrospective":[196],"low":[199,527],"methodological":[200,528],"(Table":[202],"S1).":[203],"Definitions":[204],"reported":[208],"inconsistently":[209],"(31":[210],"84":[212],"studies).":[213],"The":[214,248,512,636,707,722],"pooled":[215,262],"11":[219],"(95%":[220],"confidence":[221],"interval":[222],"9":[223],"13)%,":[225],"higher":[227,474,619],"children":[230],"than":[231,241,520],"adults":[232],"(13":[233],"versus":[234,246,293],"10%).":[235],"Acquired":[236],"recurred":[238],"more":[239,580],"often":[240],"congenital":[243],"type":[244],"7%).":[247],"approach":[250],"strongest":[253],"determinant.":[254],"Canal":[255],"wall":[256,272,420,424],"down":[257],"(CWD)":[258],"procedures":[259,602],"had":[260,289],"7%,":[266],"compared":[267,307,321],"16%":[269,323],"after":[270,438,589],"canal":[271,419,423],"up":[273,346],"(CWU).":[274],"Within":[275],"subtypes,":[276],"CWU":[277,467],"tympanoplasty/tympanomastoidectomy":[278,288],"associated":[280,461],"highest":[283],"rate,":[285],"whereas":[286,611],"CWD":[287,449,601],"lowest":[291],"(19":[292],"1%).":[294],"Adjunctive":[295],"techniques":[296],"protective;":[298],"mastoid":[299,451],"obliteration":[300,604],"reduced":[301,316,608],"9%":[306],"29%":[309],"without":[310],"obliteration,":[311,452],"complete":[313],"ossicular":[314,453,606],"reconstruction":[315,607],"6%":[320],"no":[325,639,710],"reconstruction.":[326],"Cumulative":[327],"analysis":[328],"revealed":[329],"that":[330,353,429,547],"increased":[334],"time:":[336],"7%":[337],"at":[338,342,349,718],"12":[339],"months,":[340,344],"18%":[341],"60":[343],"39%":[348],"15":[350],"years,":[351],"highlighting":[352],"short":[354],"times":[356],"markedly":[357],"underestimated":[358],"burden":[360],"(Fig.":[361],"1).":[362],"In":[363,487,586],"adjusted":[364],"meta-regression":[365],"analysis,":[366,647,657],"increasing":[367],"age":[368],"(\u03b2":[369,377],"=":[370,373,378,381,389,392],"0.0036,":[371],"P":[372,380,391],"0.006),":[374],"surgery":[376,386,506,591,613],"0.0153,":[379],"0.029),":[382],"planned":[384],"second-look":[385,457,505],"(protective;":[387],"\u03b2":[388],"\u22120.0145,":[390],"0.030)":[393],"predicted":[395],"recurrence.":[396],"Pooled":[397],"management,":[404],"stratified":[405],"duration,":[408],"intent,":[414],"technique":[417],"CWD,":[418],"down;":[421],"CWU,":[422],"up.":[425],"demonstrated":[428],"approximately":[430],"one":[431],"ten":[433],"experience":[435],"recurrent":[436,543],"continuing":[443],"rise":[445],"over":[446],"follow-up.":[448,600],"procedures,":[450],"reconstruction,":[454],"proactive":[456],"operations":[458],"consistently":[460],"lower":[463],"risk.":[465,475,620],"Conversely,":[466],"approaches":[468],"advanced-stage":[470],"These":[476],"findings":[477],"are":[478,627,732],"clinically":[479],"relevant":[480,559],"for":[481],"decision-making":[483],"counselling.":[486],"particular,":[488],"sharp":[490],"increase":[491],"beyond":[494],"5":[495],"years":[496],"underscores":[497],"importance":[499],"surveillance,":[502],"whether":[503],"diffusion-weighted":[508],"magnetic":[509],"resonance":[510],"imaging5.":[511],"results":[513],"must":[514],"be":[515],"interpreted":[516],"caution.":[518],"More":[519],"90%":[521],"quality,":[529],"heterogeneity":[531],"substantial.":[533],"Most":[534],"did":[536],"not":[537,570],"clearly":[538],"distinguish":[539],"residual":[540],"from":[541,734],"true":[542],"disease,":[544],"limitation":[546],"future":[548],"prospective":[549,624],"should":[551],"address":[552],"use":[554],"standardized":[556],"definitions.":[557],"Other":[558],"outcomes,":[560],"such":[561],"as":[562],"hearing,":[563],"complications,":[564],"life,":[568],"here;":[572],"integrating":[573],"these":[574],"alongside":[575],"would":[577],"provide":[578],"balanced":[581],"appraisal":[582],"strategies.":[585],"conclusion,":[587],"remained":[592],"common,":[593],"rising":[594],"nearly":[596],"40%":[597],"risk,":[610],"paediatric":[615],"conferred":[617],"Standardized":[621],"definitions":[622],"needed":[628],"refine":[630],"strategies":[632],"surveillance":[634],"protocols.":[635],"authors":[637,708],"funding":[640],"declare.":[642],"Saqr":[643],"Massoud":[644],"(Conceptualization,":[645,655,697],"Formal":[646,656],"Investigation,":[648,658,668,678,687],"Methodology,":[649,659,669,679,688,698],"Validation,":[650,660,703],"Writing\u2014original":[651,661],"draft),":[652,662],"Raed":[653],"Farhat":[654],"Uday":[663],"Abd":[664],"Elhadi":[665],"(Data":[666,676,685],"curation,":[667,677,686],"Writing\u2014review":[670,680,691,704],"&":[671,681,692,705],"editing),":[672,682,693],"Bashir":[673],"Abu":[674],"Abed":[675],"Shlomo":[683],"Merchavy":[684],"Software,":[689],"Visualization,":[690],"Alaa":[695],"Safia":[696],"Project":[699],"administration,":[700],"Resources,":[701],"Supervision,":[702],"editing)":[706],"declare":[709],"conflict":[711],"interest.":[713],"Supplementary":[714],"material":[715],"available":[717,733],"BJS":[719],"Open":[720],"online.":[721],"data":[723],"sets":[724],"used":[725],"and/or":[726],"analysed":[727],"present":[730],"corresponding":[736],"author":[737],"reasonable":[739],"request.":[740]},"counts_by_year":[{"year":2026,"cited_by_count":4}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2025-11-06T00:00:00"}