Learning Objectives:

Introduction: Cholesteatoma is a serious middle ear disease, affecting both adults and children. it is more special in children. Occurred on a pneumatised mastoid, cholesteatoma in children is more aggressive with a great potential of extension and a high tendency to recurrence. Although in literature many authors support this hypothesis, others still disagree with this point of view at the present time. Therefore, the particularity of cholesteatoma in children is a reality or just a myth? Our study aims to emphasize on this issue.

Materials and methods: with a longitudinal-type study on 82 cases of acquired cholesteatoma in children at ENT department of Ferhat Abbas university and Chawki & Achwak clinic between January 2004 and December 2015. The aim of this work is to illustrate the clinical,para clinical and therapeutic features of cholestatoma in the pediatric population and highlight the main characteristics.

Results: The main reason for consultation is largely driven by the fetid otorrhea (96.5%), hearing loss, however,is well behind (66.7%). It is worth noting that Tubal dysfunction, adaptation disease, allergy are very common and haracterize children. CT scan is the imaging method of choice in the preoperative evaluation. It provides useful details, particularly regarding the pneumatisation of the mastoid.Thus, confirming that cholesteatoma in children occurs on a very pneumatised mastoid which usually belongs to younger children. Granulation tissue in the middle ear and the mastoid cavities, denuded facial nerve, very extensive cholesteatoma are the most common difficulties to remove the disease and to prevent the recurrence which is absolutely higher than that observed in adults.

Conclusion: Cholesteatoma of the child is special because the child himself is special. The large clinical latency And the misdiagnoses complicate not only the task of the surgeon but also the prognosis with a high potential of recurrence whatever the technique used.