Retrograde mastoidectomy on demand with soft-wall reconstruction in pediatric cholesteatoma.
CONCLUSIONS
Retrograde mastoidectomy with soft-wall reconstruction is an effective technique that can be used to lower the recurrence rate of cholesteatoma in the pediatric population.


OBJECTIVE
To evaluate surgical outcomes of retrograde mastoidectomy when using soft-wall reconstruction in pediatric cholesteatoma.


METHODS
A total of 25 children underwent cholesteatoma removal surgery employing soft-wall reconstruction. The cases were retrospectively reviewed. Average follow-up time was 48.7 months. In order to fully expose and extirpate the disease, the bony canal wall was removed in association with a retrograde-type mastoidectomy in all cases. The posterior ear canal defect was then reconstructed using soft tissue; i.e. temporal fascia and canal wall skin. The incidence and localization of residual and recurrent cholesteatoma, preoperative and postoperative audiogram results, pure-tone average (PTA), and air-bone gap (ABG) were assessed.


RESULTS
Residual cholesteatoma was detected in 5 (20%) of 25 ears while recurrent cholesteatoma occurred in 1 (4%) of 25 ears. The mean preoperative PTA of air conduction (AC) was 39.1 dB, while the preoperative PTA of the ABGs was 28.8 dB. The mean postoperative PTA-AC and PTA-ABG were 20.9 dB and 11.7 dB, respectively. The mean hearing gain was 18.2 dB. The differences between the pre- and postoperative values were statistically significant (p < 0.05).
Hatano
Miyako
M
Department of Otolaryngology - Head and Neck Surgery, Kanazawa University Hospital, Ishikawa, Japan.
Ito
Makoto
M
Yoshizaki
Tomokazu
T
D000293:Adolescent; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome