Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-23T19:29:42.847Z Has data issue: false hasContentIssue false
  • English
  • Français

Cholesteatoma surgery in children: 10-year retrospective review

Published online by Cambridge University Press:  06 February 2012

V Visvanathan ,
H Kubba  and
M S C Morrissey
V Visvanathan*
Affiliation:
Department of ENT/Head and Neck Surgery, Royal Hospital for Sick Children, Glasgow, Scotland, UK
H Kubba
Affiliation:
Department of ENT/Head and Neck Surgery, Royal Hospital for Sick Children, Glasgow, Scotland, UK
M S C Morrissey
Affiliation:
Department of ENT/Head and Neck Surgery, Royal Hospital for Sick Children, Glasgow, Scotland, UK
*
Address for correspondence: Mr V Visvanathan, Specialist Trainee, Department of ENT/Head and Neck Surgery, Royal Hospital for Sick Children, Dalnair St, Glasgow G3 8SJ, Scotland, UK Fax: +44 (0)141 201 0001 E-mail: vikranth.visvanathan@nhs.net
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To review outcomes following paediatric cholesteatoma surgery performed between 1999 and 2009 in a tertiary paediatric ENT unit.

Study design:

Retrospective case note review.

Results:

A total of 137 mastoid procedures were recorded. Fifty-four per cent of children were observed to have disease involving the entire middle-ear cleft and mastoid complex. The revision rate was 25 per cent. Time to recurrence was one to three years in 17 patients, three to six years in five patients, and six to nine years in three cases. Eight of 25 revision cases demonstrated spontaneous improvement in air conduction thresholds following primary surgery. A high facial ridge and inadequate meatoplasty correlated highly with disease recurrence.

Conclusion:

Children tend to present with aggressive disease. Disease extent and ossicular chain involvement are associated with a higher risk of recurrent disease. Spontaneous improvement in hearing thresholds following cholesteatoma surgery should alert the clinician to recurrent disease.

Keywords

ChildCholesteatomaMastoidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 5 , May 2012 , pp. 450 - 453
Copyright
Copyright © JLO (1984) Limited 2012

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.)

References

1Sohet, JA, De Jong, AL. The management of pediatric cholesteatoma. Otolaryngol Clin North Am 2002;35:841–51CrossRefGoogle Scholar
2Friedberg, J. Congenital cholesteatoma. Laryngoscope 1994;104:1–24CrossRefGoogle ScholarPubMed
3Fageeh, NA, Schloss, MD, Elahi, MM, Tewfik, TL, Manoukian, JJ. Surgical treatment of cholesteatoma in children. J Otolaryngol 1999;28:309–12Google ScholarPubMed
4Brackmann, D, Schelton, C, Arriaga, MA. Canal wall down mastoidectomy. In: Arriaga, MA, ed. Otologic Surgery, 2nd edn.Philadelphia: WB Saunders, 2001;178–90Google Scholar
5Nikolopoulos, TP, Gerbesiotis, P. Surgical management of cholesteatoma: the two main options and the third way – atticotomy/limited mastoidectomy. Int J Pediatr Otorhinolaryngol 2009;73:1222–7CrossRefGoogle ScholarPubMed
6Sheehy, JL, Brackmann, DE, Graham, MD. Cholesteatoma recurrence: residual and recurrent disease. A review of 1,024 cases. Ann Otol Rhinol Laryngol 1977;86:451–62Google Scholar
7Wormald, PJ, Nilssen, ELK. The facial ridge and the discharging mastoid cavity. Laryngoscope 1998;108:92–6Google Scholar
8Monsell, EM. New and revised reporting guidelines from the Committee on Hearing and Equilibrium. Otolaryngol Head Neck Surg 1995;113:176–8CrossRefGoogle Scholar
9Ahn, SH, Seung, HO, Chang, SO, Kim, CS. Prognostic factors of recidivism in pediatric cholesteatoma surgery. Int J Pediatr Otorhinolaryngol 2003;67:1325–30CrossRefGoogle ScholarPubMed
10Tos, M, Lau, T. Late results of surgery in different cholesteatoma types. ORL J Otorhinolaryngol Relat Spec 1989;51:33–49CrossRefGoogle ScholarPubMed
11Roger, G, Denoyelle, F, Chauvi, P, Schlegel-Stuhl, N, Garabedian, EN. Predictive risk factors of residual cholesteatoma in children: a study of 256 patients. Am J Otolaryngol 1997;18:550–8Google Scholar
12Stangerup, SE, Drozdziewicz, D, Tos, M. Cholesteatoma in children, predictors and calculation of recurrence rates. Int J Pediatr Otorhinolaryngol 1999;49(suppl 1):S69–73CrossRefGoogle ScholarPubMed
13Stern, SJ, Fazekas-May, M. Cholesteatoma in the pediatric population: prognostic indicators for surgical decision making. Laryngoscope 1992;102:1349–52CrossRefGoogle ScholarPubMed
14Rosenfiled, RM, Moura, RL, Bluestone, CD. Predictors of residula-recurrent cholesteatoma in children. Arch Otolaryngol Head Neck Surg 1992;118:384–91Google Scholar
15Silvola, J, Palva, T. One-stage revision surgery for pediatric cholesteatoma: long-term results and comparison with primary surgery. Int J Pediatr Otorhinolaryngol 2000;56:135–9Google Scholar
16Roden, D, Honrubia, VF, Weit, R. Outcome of residual cholesteatoma and hearing in mastoid surgery. J Otolaryngol 1996;25:178–81Google ScholarPubMed
17Hirsch, BE, Kamerer, DB, Doshi, S. Single-stage management of cholesteatoma. Otolaryngol Head Neck Surg 1992;106:351–4CrossRefGoogle ScholarPubMed
18Toner, JG, Smyth, GD. Surgical treatment of cholesteatoma: a comparison of three techniques. Am J Otolaryngol 1990;11:247–9Google ScholarPubMed
19Gray, L, Leyland, AH. A multilevel analysis of diet and socio-economic status in Scotland: investigating the ‘Glasgow effect’. Public Health Nutr 2009;12:1351–8CrossRefGoogle ScholarPubMed
20Gray, L. Comparisons of Health-related Behaviours and Health Measures in Greater Glasgow with Other Regional Areas in Europe. Glasgow: Glasgow Centre for Population Health, 2008Google Scholar