Long-term outcome of atticotomy for cholesteatoma in children.
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.
DeRowe
Ari
A
Department of Otolaryngology-Head and Neck Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. aderowe@post.tau.ac.il
Stein
Gidon
G
Fishman
Gadi
G
Berco
Eli
E
Avraham
Shabtai
S
Landsberg
Roee
R
Sadé
Jacob
J
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