Cholesteatoma in children: techniques and results

Soldati, D.; Mudry, Albert

doi:10.1016/s0165-5876(00)00298-6

Cited by 26 publications

(14 citation statements)

References 10 publications

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“…Open cavity mastoidectomy has the advantages of allowing the surgeon to examine the operative field and to remove all the cholesteatomas in the mastoid and middle ear as well as in the epitympanum. Consequently, the postoperative recurrence rate of cholesteatoma with this approach is far lower than with ICW mastoidectomy (11-14). On the other hand, atticoantrotomy also has shown a lower rate of recurrence than ICW mastoidectomy (15) Abramson et al have reported that the recurrence of cholesteatoma was occurred after atticotomy in 17% and ICW in 35%.…”

Section: Discussionmentioning

confidence: 96%

Clinical Results of Atticoantrotomy with Attic Reconstruction or Attic Obliteration for Patients with an Attic Cholesteatoma

Kim

Choi

Chung

2009

Clin Exp Otorhinolaryngol

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ObjectivesWe aimed to investigate the clinical results of atticoantrotomy in patients with an attic cholesteatoma.MethodsNinety-eight ears in 98 patients were operated on using atticoantrotomy between October 2002 and December 2006. A retrospective review of the otology database (operative findings and methods, postoperative physical examination and pre- and postoperative audiometry) was performed.ResultsThere were 58 female and 40 male patients with a mean age of 40 yr. The cholesteatoma was limited to the attic region in 24 patients (24.5%); attic with antrum in 18 (18.4%); and attic with antrum and middle ear in 56 (57.1%). Attic obliteration was performed in 59 patients (60.2%), attic reconstruction in 39 (39.8%) and ossicular reconstruction was performed in 59 (60.2%). The mean preoperative and postoperative air-bone gaps were 29.2±13.5 dB and 25.0±15.4 dB, respectively (P=0.01) and the mean preoperative and postoperative high-tone bone conduction levels were 14.5±9.7 dB and 15.23±14.0 dB, respectively (P=0.411). A recurrent cholesteatoma was detected in 3 ears (3%) and revision surgery was performed on these patients.ConclusionAtticoantrotomy showed a low recurrence rate and no deterioration in hearing levels. If there is a intact malleus head or body of incus, attic reconstruction was possible and this procedure could lead to improved hearing. However, postoperative retraction occurred in 18% of patients, a problem that will need to be solved in the future.

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Section: Discussionmentioning

confidence: 96%

Clinical Results of Atticoantrotomy with Attic Reconstruction or Attic Obliteration for Patients with an Attic Cholesteatoma

Kim

Choi

Chung

2009

Clin Exp Otorhinolaryngol

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“…However, the rate of residual or recurrent cholesteatoma is generally lower in an open technique. In recent publications, rates of residual cholesteatoma in children have ranged from 22% to 54% after ICW procedures and from 7.5% to 29% after canal wall down (CWD) procedures, while rates of recurrent cholesteatoma have ranged from 3% to 40% in ICW and from 6% to 29% in CWD [9][10][11] procedures. In our series we found a recurrence rate of cholesteatoma, by using a canal wall down approach, in 26.6% of children and in 6.81% of adults.…”

Section: Discussionmentioning

confidence: 99%

Aural acquired cholesteatoma in children: Surgical findings, recurrence and functional results

Corso

Marchese

Scarano

et al. 2006

International Journal of Pediatric Otorhinolaryngology

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“…This approach is also considered to provide good access to the posterior epitympanic space and oval window niche area [9,10] . Thus, the possibility of residual cholesteatoma decrease substantially, and the need for a second look procedure becomes minimal.…”

Section: Discussionmentioning

confidence: 99%

Lateral Attic Wall Reconstruction with Glass Ionomer Bone Cement in the Management of Primary Acquired Attic Cholesteatoma in Children: A Preliminary Experience

Omran

Baki²,

Amin³

2016

Int Adv Otol

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OBJECTIVE:To assess the effectiveness of glass ionomer bone cement (GIBC) in lateral attic wall reconstruction after primary acquired attic cholesteatoma surgery. MATERIALS and METHODS:This prospective study was conducted on twenty children collected from the ENT outpatient clinics of a secondary and tertiary hospital. All patients presented with chronic suppurative otitis media with cholesteatoma of the primary acquired attic type. All patients underwent intact canal wall mastoidectomy (ICWM) with a transcanal atticotomy to address primary cholesteatoma involving the attic and the supratubal recess. Removal of the incus with or without decapitation of the malleus depended on the extension of the pathology. GIBC was used to build up the lateral attic wall in all cases. Ossiculoplasty and tympanoplasty were performed according to the extent of disease. RESULTS:All patients had integrated skin covering the reconstructed attic wall with no signs of granulation tissue formation, canal wall edema, glass ionomer extrusion, or foreign body reaction on the 6 th month, 1 st year and 2 nd year follow-up visits. Also, no persistent otorrhea was noted. The postoperative air-bone gap was significantly improved (p=0.007).CONCLUSION: GIBC could be considered as a reliable artificial material for reconstruction of the lateral attic wall after transmeatal atticotomy in ICWM, making it feasible to avoid cavity problems of canal wall down mastoidectomy, especially in children. KEYWORDS: MATERIALS and METHODSThis prospective study was conducted on twenty children presenting at the Otorhinolaryngology Outpatient Clinics of a secondary and tertiary referral hospital over a 2-year period, from April 2012 to April 2014, with primary acquired attic cholesteatoma of variable extensions to the middle ear and mastoid cavity. These patients were selected from a total of 180 chronic suppurative otitis media (CSOM) patients presenting in this period of time. Ethical ConsiderationsThe Ethical Committee of the School of Medicine approved the protocol of the study before it began; all patient parents provided written consent before participating in the study. Surgical TechniqueThe patients were subjected to preoperative evaluation, including preoperative oto-endoscopic examination, preoperative pure tone audiometry (PTA), radiological assessment, and explanation of the surgery to patient guardians.The procedure was carried out under general anesthesia in the form of ICWM through a post-auricular approach. A transcanal atticotomy was performed in all cases to ensure complete access to the anterior attic and supratubal recess area. Removal of the incus and excision of the malleus head were performed according to the extent of disease. Total clearance of cholesteatoma and granulations from the attic, antrum, and middle ear, including the sinus tympani area and supratubal recess were followed. The lateral attic wall was reconstructed with GIBC. Reconstruction of the ossicular chain depended on the degree of its involvement in the form of either inc...

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Cholesteatoma in children: techniques and results

Cited by 26 publications

References 10 publications

Clinical Results of Atticoantrotomy with Attic Reconstruction or Attic Obliteration for Patients with an Attic Cholesteatoma

Clinical Results of Atticoantrotomy with Attic Reconstruction or Attic Obliteration for Patients with an Attic Cholesteatoma

Aural acquired cholesteatoma in children: Surgical findings, recurrence and functional results

Lateral Attic Wall Reconstruction with Glass Ionomer Bone Cement in the Management of Primary Acquired Attic Cholesteatoma in Children: A Preliminary Experience

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