Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-06-09T15:38:18.097Z Has data issue: false hasContentIssue false
  • English
  • Français

Is there a clinical difference in paediatric congenital cholesteatoma according to age?

Published online by Cambridge University Press:  15 August 2022

C H Shin ,
W S Kang ,
H J Park ,
J W Chung  and
J H Ahn Open the ORCID record for J H Ahn [Opens in a new window]
C H Shin
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
W S Kang
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
H J Park
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
J W Chung
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
J H Ahn*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
*
Author for correspondence: Dr J H Ahn, Department of Otorhinolaryngology – Head and Neck Surgery, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea E-mail: meniere@amc.seoul.kr Fax: +82 2489 2773
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study aimed to analyse surgical outcomes of paediatric patients with congenital cholesteatoma according to age.

Method

This was a retrospective study reviewing the records of 186 children (136 boys and 50 girls) from August 1993 to January 2016. Patients were divided into three age groups (equal to or less than 3 years, over 3 and less than 7 years, and 7 to 15 years).

Results

There were significant differences in chief complaints, location of cholesteatoma in the middle ear, computed tomography findings, operation methods, ossicular erosion and type of cholesteatoma sac among the three groups. In addition, older age, open type cholesteatoma, ossicular erosion and mastoid invasion of cholesteatoma increased the recurrence rate after surgery. However, despite higher pre-operative air–bone gap in older children, hearing can be improved enough after proper surgery with ossicular reconstruction.

Conclusion

Delayed detection of paediatric cholesteatoma can lead to extensive disease and the need for an aggressive operation, which can result in worse hearing outcomes and an increased recurrence risk.

Keywords

PaediatricsCongenitalCholesteatomaMiddle EarAge Distribution
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 6 , June 2023 , pp. 643 - 650
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr J H Ahn takes responsibility for the integrity of the content of the paper

References

Castle, JT. Cholesteatoma pearls: practical points and update. Head Neck Pathol 2018;12:419–2910.1007/s12105-018-0915-5CrossRefGoogle ScholarPubMed
Yung, M, Tono, T, Olszewska, E, Yamamoto, Y, Sudhoff, H, Sakagami, M et al. EAONO/JOS Joint Consensus Statements on the Definitions, Classification and Staging of Middle Ear Cholesteatoma. J Int Adv Otol 2017;13:1–8CrossRefGoogle ScholarPubMed
Bennett, M, Warren, F, Jackson, GC, Kaylie, D. Congenital cholesteatoma: theories, facts, and 53 patients. Otolaryngol Clin North Am 2006;39:1081–94CrossRefGoogle ScholarPubMed
James, AL, Papsin, BC. Some considerations in congenital cholesteatoma. Curr Opin Otolaryngol Head Neck Surg 2013;21:431–910.1097/MOO.0b013e328364b457CrossRefGoogle ScholarPubMed
Nelson, M, Roger, G, Koltai, PJ, Garabedian, EN, Triglia, JM, Roman, S et al. Congenital cholesteatoma: classification, management, and outcome. Arch Otolaryngol Head Neck Surg 2002;128:810–410.1001/archotol.128.7.810CrossRefGoogle ScholarPubMed
Kuo, CL, Shiao, AS, Yung, M, Sakagami, M, Sudhoff, H, Wang, CH et al. Updates and knowledge gaps in cholesteatoma research. Biomed Res Int 2015;2015:85402410.1155/2015/854024CrossRefGoogle ScholarPubMed
Bylander, A. Comparison of eustachian tube function in children and adults with normal ears. Ann Otol Rhinol Laryngol Suppl 1980;89:20–4CrossRefGoogle ScholarPubMed
Bylander, A, Tjernstrom, O. Changes in Eustachian tube function with age in children with normal ears. A longitudinal study. Acta Otolaryngol 1983;96:467–7710.3109/00016488309132733CrossRefGoogle ScholarPubMed
Levenson, MJ, Michaels, L, Parisier, SC. Congenital cholesteatomas of the middle ear in children: origin and management. Otolaryngol Clin North Am 1989;22:941–5410.1016/S0030-6665(20)31369-4CrossRefGoogle ScholarPubMed
Lim, HW, Yoon, TH, Kang, WS. Congenital cholesteatoma: clinical features and growth patterns. Am J Otolaryngol 2012;33:538–4210.1016/j.amjoto.2012.01.001CrossRefGoogle ScholarPubMed
Lynrah, ZA, Bakshi, J, Panda, NK, Khandelwal, NK. Aggressiveness of pediatric cholesteatoma. Do we have an evidence? Indian J Otolaryngol Head Neck Surg 2013;65:264–810.1007/s12070-012-0548-zCrossRefGoogle ScholarPubMed
Lima A, Fontes, Moreira F, Carvalho, Menezes A, Sousa, Costa I, Esteves, Azevedo, C, Breda, MS. Is pediatric cholesteatoma more aggressive in children than in adults? A comparative study using the EAONO/JOS classification. Int J Pediatr Otorhinolaryngol 2020;138:110170CrossRefGoogle Scholar
Cho, HS, Kim, HG, Jung, DJ, Jang, JH, Lee, SH, Lee, KY. Clinical aspects and surgical outcomes of congenital cholesteatoma in 93 children: increasing trends of congenital cholesteatoma from 1997 through 2012. J Audiol Otol 2016;20:168–7310.7874/jao.2016.20.3.168CrossRefGoogle ScholarPubMed
Roger, G, Denoyelle, F, Chauvin, P, Schlegel–Stuhl, N, Garabedian, EN. Predictive risk factors of residual cholesteatoma in children: a study of 256 cases. Am J Otol 1997;18:550–8Google ScholarPubMed
Stangerup, SE, Drozdziewicz, D, Tos, M. Cholesteatoma in children, predictors and calculation of recurrence rates. Int J Pediatr Otorhinolaryngol 1999;49:S69–73CrossRefGoogle ScholarPubMed
Reuven, Y, Raveh, E, Ulanovski, D, Hilly, O, Kornreich, L, Sokolov, M. Congenital cholesteatoma: clinical features and surgical outcomes. Int J Pediatr Otorhinolaryngol 2022;156:111098CrossRefGoogle ScholarPubMed
Glikson, E, Feinmesser, G, Sagiv, D, Wolf, M, Migirov, L, Shapira, Y. Trans-canal endoscopic ear surgery and canal wall-up tympano-mastoidectomy for pediatric middle ear cholesteatoma. Eur Arch Otorhinolaryngol 2019;276:3021–610.1007/s00405-019-05588-1CrossRefGoogle ScholarPubMed
Nevoux, J, Lenoir, M, Roger, G, Denoyelle, F, Ducou Le Pointe, H et al. Childhood cholesteatoma. Eur Ann Otorhinolaryngol Head Neck Dis 2010;127:143–5010.1016/j.anorl.2010.07.001CrossRefGoogle ScholarPubMed
Potsic, WP, Korman, SB, Samadi, DS, Wetmore, RF. Congenital cholesteatoma: 20 years' experience at The Children's Hospital of Philadelphia. Otolaryngol Head Neck Surg 2002;126:409–14CrossRefGoogle ScholarPubMed
Potsic, WP, Samadi, DS, Marsh, RR, Wetmore, RF. A staging system for congenital cholesteatoma. Arch Otolaryngol Head Neck Surg 2002;128:1009–12CrossRefGoogle ScholarPubMed
Bacciu, A, Di Lella, F, Pasanisi, E, Gambardella, I, Saccardi, MS, Bacciu, S et al. Open vs closed type congenital cholesteatoma of the middle ear: two distinct entities or two aspects of the same phenomenon? Int J Pediatr Otorhinolaryngol 2014;78:2205–910.1016/j.ijporl.2014.10.014CrossRefGoogle ScholarPubMed
Stapleton, AL, Egloff, AM, Yellon, RF. Congenital cholesteatoma: predictors for residual disease and hearing outcomes. Arch Otolaryngol Head Neck Surg 2012;138:280–510.1001/archoto.2011.1422CrossRefGoogle ScholarPubMed
James, AL, Cushing, S, Papsin, BC. Residual cholesteatoma after endoscope-guided surgery in children. Otol Neurotol 2016;37:196–20110.1097/MAO.0000000000000948CrossRefGoogle ScholarPubMed
Osborn, AJ, Papsin, BC, James, AL. Clinical indications for canal wall-down mastoidectomy in a pediatric population. Otolaryngol Head Neck Surg 2012;147:316–22CrossRefGoogle Scholar
Chadha, NK, Jardine, A, Owens, D, Gillett, S, Robinson, PJ, Maw, AR. A multivariate analysis of the factors predicting hearing outcome after surgery for cholesteatoma in children. J Laryngol Otol 2006;120:908–1310.1017/S0022215106002179CrossRefGoogle ScholarPubMed