Cholesteatoma in the pediatric population: prognostic indicators for surgical decision making.
A review of surgical therapy for pediatric cholesteatoma at the Arkansas Children's Hospital was performed. Fifty-three children treated surgically for cholesteatoma were studied over a 10-year period. Primary acquired, or attic retraction cholesteatomas, were generally treated with a canal up tympanomastoidectomy; there were very few complications or secondary procedures in this group. Middle ear or secondary acquired cholesteatomas were initially treated by both canal up and canal down procedures; however, a large percentage of these patients eventually required an open cavity procedure. The presence of cholesteatoma in the sinus tympani strongly predicted failure to control disease with a canal up procedure (P < .05); conversely, the absence of matrix in the sinus tympani was predictive for success when a canal up procedure was used for attic cholesteatoma (P < .05). Finally, it was determined that follow-up was not adequate in our patient population. With this in mind, guidelines for the management of pediatric cholesteatoma will be presented.
Stern
S J
SJ
Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock 72205.
Fazekas-May
M
M
D000293:Adolescent; D001299:Audiometry; D002648:Child; D002781:Cholesteatoma / Q000473:pathology / Q000517:prevention & control / Q000601:surgery*; D003657:Decision Making; D004424:Ear Canal / Q000601:surgery; D004427:Ear Diseases / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D004432:Ear, Middle / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006309:Hearing / Q000502:physiology; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008722:Methods; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome