Cholesteatoma in Children

Sie, Kathleen C.Y.

doi:10.1016/s0031-3955(05)70517-4

Cited by 23 publications

(17 citation statements)

References 23 publications

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“…In the CWU procedure, the posterior wall is preserved, maintaining the normal anatomy of the ear canal. 1 A third procedure may involve obliteration of the mastoid cavity by applying materials that effectively obliterate the cavity. A recent review by van der Toom et al 2 has shown recurrence rates as low as 4.6% for both CWD and CWU with obliteration.…”

Section: Introductionmentioning

confidence: 99%

Recurrence of Cholesteatoma - A Retrospective Study Including 1,006 Patients for More than 33 Years

Møller

Pedersen

Grosfjeld

et al. 2019

Int Arch Otorhinolaryngol

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Introduction Cholesteatomas are benign tumors consisting of skin, and growing inside a retraction pocket in the tympanic membrane. Cholesteatomas can occupy the entirety of the middle ear, and are known for their osteolytic capabilities. Surgery is the only curative treatment for cholesteatomas. Objective To describe the risk of recurrence after first-time surgically-treated middle-ear cholesteatoma (STMEC1) on the island of Funen from 1983 to 2015. Methods Cases of STMEC1 were identified in the Danish National Hospital Register. The medical records were reviewed. Time-to-event analyses were applied. The ears were followed from STMEC1 to a secondary cholesteatoma, emigration, death, or end of follow-up. Results Records from 1,006 patients with STMEC1 were reviewed. A total of 54 patients were submitted to surgery on both ears. The total sample consisted of 1,060 ears with STMEC1; 300 were children's (< 16 years) ears, and 760 were adult's ears. The total observation time was of 12,049 years.The overall estimated proportion with recurrence 5 years after surgery was of 37% in children and of 15% in adults. The older the child was at the first surgery, the risk decreased by 7% per year. In children, canal wall up (CWU) mastoidectomy without obliteration was associated with a hazard ratio for recurrence of 1.9 (95% confidence interval [95%CI]: 1.2–3.0) compared with CWU with obliteration. Conclusion Compared with adults, children were had 2.6 times more risk of recurrence. Procedures performed without mastoidectomy had the lowest risk of recurrence. In children, obliteration was associated with a significantly lower risk of recurrence. However, patients were not randomized regarding the surgical approach; thus, the association between approach and risk of recurrence was likely influenced by confounding factors.

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Section: Introductionmentioning

confidence: 99%

Recurrence of Cholesteatoma - A Retrospective Study Including 1,006 Patients for More than 33 Years

Møller

Pedersen

Grosfjeld

et al. 2019

Int Arch Otorhinolaryngol

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“…First, very extensive disease is found more frequently in children compared to adults [1] and secondly, higher rates of residual and recurrent disease have been documented in the pediatric population [1][2][3][4][5][6]. The literature is replete with the studies on the comparative evaluation of the pediatric and the adult cholesteatoma [2][3][4][5][7][8][9]. Most of these studies have been performed in a retrospective manner.…”

Section: Introductionmentioning

confidence: 99%

Aggressiveness of Pediatric Cholesteatoma. Do We Have an Evidence?

Lynrah

Bakshi

Panda

et al. 2012

Indian J Otolaryngol Head Neck Surg

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To compare pediatric and adult patients, affected by cholesteatoma for the clinical presentation, disease extent and final outcome. This is a prospective study in which 60 cases of unsafe chronic suppurative otitis media with cholesteatoma were included. These cases were divided into two groups of 30 cases each on the basis of age. All patients were subjected to detailed clinical examination. A high resolution computed tomography of the temporal bone was done in all the cases. An innovative grading system was devised to grade the disease. The patients were subjected to canal wall down mastoidectomy and were evaluated postoperatively for resolution of the symptoms, hearing and cavity problems. Granulation tissue along with cholesteatoma was more common among children (p < 0.01), whereas cholesteatoma alone was more common among adults. There was excellent correlation between the radiological and surgical findings. It was seen that higher the grade of the disease, the greater was the risk of complications and recidivism (p < 0.05). Recidivism was significantly higher in children (p < 0.05) whereas complications were equally common in both the groups. Hearing improvement was equivocal in both groups. Presence of granulation tissue along with cholesteatoma in children causes more aggressive disease with higher recidivism rate.

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“…In addition to general risks of surgery (bleeding, infection), complications of middle ear surgery include further hearing loss, facial nerve palsy, and CSF leak. [5][6][7][8] Recurrence rates for cholesteatomas after primary cholesteatoma surgery vary widely, depending upon the method of surgery and the duration of follow-up. Canal-wall-up mastoidectomy is generally accompanied by a high rate of recurrent disease; some studies report a 5-year recurrence rate as high as 57%.…”

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confidence: 99%

“…Canal-wall-up mastoidectomy is generally accompanied by a high rate of recurrent disease; some studies report a 5-year recurrence rate as high as 57%. [7][8][9] The more invasive canal-wall-down approach is reported to have lower recurrence rates. 5 If recurrence is suspected clinically, on the basis of otoscopy and audiometry, until now second-look surgery was indicated.…”

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confidence: 99%