title: Long-term outcome of atticotomy for cholesteatoma in children.
abstract: OBJECTIVE
  To evaluate the long-term outcome of atticotomy (AT) surgery for cholesteatoma in children.
  
  
  METHODS
  Case series, retrospective chart review.
  
  
  METHODS
  General otology practice in a teaching hospital.
  
  
  METHODS
  Fifty-three children aged 5 to 16 years old with cholesteatoma limited to the attic and middle ear who underwent AT between the years 1979 to 1994.
  
  
  METHODS
  AT consisting of removal of cholesteatoma confined mainly to the attic. The procedure consists of removal of the lateral attic wall (scutum) and involved ossicles with excision of the cholesteatoma and tympanic membrane grafting with temporalis fascia, leaving a small attical cavity. The mastoid antrum was left intact.
  
  
  METHODS
  Disease recurrence, middle ear status, hearing results, and the need for further surgery.
  
  
  RESULTS
  Mean follow up was 5.1 (+/-3.6) years. Eleven (21%) children required completion canal wall down tympanomastoidectomy because of residual disease or recurrence. The mean preoperative speech recognition threshold was 39.4 +/- 13.4 dB. The mean postoperative speech recognition threshold was 34.5 +/- 15.4, an improvement of 6.1 dB compared with the preoperative level. Last follow-up examination revealed a dry ear in all cases but one.
  
  
  CONCLUSIONS
  In selected cases, AT can be a less invasive option in children with cholesteatoma limited to the attic and middle ear.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. aderowe@post.tau.ac.il
authors.forename: Ari
authors.initials: A
authors.lastname: DeRowe
authors.forename: Gidon
authors.initials: G
authors.lastname: Stein
authors.forename: Gadi
authors.initials: G
authors.lastname: Fishman
authors.forename: Eli
authors.initials: E
authors.lastname: Berco
authors.forename: Shabtai
authors.initials: S
authors.lastname: Avraham
authors.forename: Roee
authors.initials: R
authors.lastname: Landsberg
authors.forename: Jacob
authors.initials: J
authors.lastname: Sadé
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013506:Otologic Surgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D013069:Speech Reception Threshold Test; D016896:Treatment Outcome