Surgical treatment of cholesteatoma in children.
OBJECTIVE
To present our experience in the surgical treatment of cholesteatoma in children.


METHODS
Retrospective clinical trial.


METHODS
Charts of 114 patients who met the inclusion criteria of the study were examined. Surgical results were compared with respect to applied surgical methods. Cholesteatoma recidivism (CR) and hearing improvement were the main parameters which were examined.


RESULTS
The mean age was 13 years and mean follow-up period was 3.7 years. A total of 200 operations performed on 114 children: 114 children operated at the first stage, 84 children underwent a second surgery, and 2 a third surgery. At initial operation; canal wall-up (CWU) tympanomastoidectomy was the choice of surgical procedure in 35 (31%) patients, and canal wall-down (CWD) tympanomastoidectomy was preferred for the other 79 (69%) patients. At final analysis; 26 of 114 (23%) patients had CWU procedure, 67 patients (59%) had CWD procedure and 21 patients (18%) had radical mastoidectomy. (CR) rate was 26 and 16%, respectively for CWU and CWD procedures for initial surgeries (P = 0.248). Hearing improvement was achieved in 36% of CWU procedures and 38% of CWD procedures (P = 0.957). Hearing deterioration was observed in 36% of CWU procedures and 47% of CWD procedures (P = 0.328).


CONCLUSIONS
There was no significant difference between CWU and CWD procedures with respect to CR, hearing improvement, and hearing deterioration. Therefore, choose of surgical procedure should be individualized for each patient. In our opinion; open techniques must be employed in the presence of extensive disease, whereas the closed technique is reserved for those with a more localized problem.
Göçmen
Hakan
H
ENT Department, Ministry of Health, Ankara Research and Training Hospital, Ankara, Turkey.
Kiliç
Rahmi
R
Ozdek
Ali
A
Kizilkaya
Zeynep
Z
Safak
M Asim
MA
Samim
Erdal
E
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000503:physiopathology / Q000601:surgery*; D003657:Decision Making; D004424:Ear Canal / Q000601:surgery*; D005260:Female; D006309:Hearing; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome