Predictors of residual-recurrent cholesteatoma in children.
The aggressive nature of childhood cholesteatoma has generated much controversy regarding the optimal management of this challenging disorder. To identify potential predictors of residual-recurrent disease, we studied 232 children (244 ears) treated with 427 surgical procedures between 1973 and 1990. Cause of the primary cholesteatoma was congenital in 43 patients (18%), acquired in 83 (36%), and unknown in 106 (46%). Of 90 patients with residual-recurrent disease, 21 (23%) instances were detected during a second-look surgical exploration. The 3- and 5-year residual-recurrence rates were 48% and 57%, respectively. Development of residual-recurrent disease was associated with ossicular erosion (Cox regression) but not with status of the canal wall (up vs down) during tympanomastoidectomy. This study suggests a need for intense and prolonged postoperative follow-up of children with cholesteatoma, especially those with ossicular erosion.
Rosenfeld
R M
RM
Pittsburgh Otitis Media Research Center, PA.
Moura
R L
RL
Bluestone
C D
CD
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002781:Cholesteatoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D004427:Ear Diseases / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D004429:Ear Ossicles / Q000473:pathology; D004432:Ear, Middle / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007223:Infant; D008297:Male; D008416:Mastoid / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D012086:Reoperation; D016019:Survival Analysis