title: [Clinical and pathological features of cholesteatoma in young children].
abstract: BACKGROUND
  Children cholesteatoma have been shown to demonstrate aggressive growth with greater extension and higher rates residual and recurrent disease compared with adults, due to anatomic and physiologic differences.
  
  
  OBJECTIVE
  This study aimed to determine the clinical and pathological features of cholesteatoma in young children less than 7 years of age.
  
  
  METHODS
  Retrospective review of a group of 23 children (24 ears) who had cholesteatoma surgery between 1996 and 2004. Patients ages ranged from 1.8 to 7 years, follow up from 3.5 to 12 years (mean 7.4). Medical history (previous otorrhea, hearing loss) and contralateral ear status was analyzed. The extent of cholesteatoma and ossicular destruction for attic, pars tensa I and pars tensa II type and congenital of cholesteatoma was graded using of Saleh and Mills classification. Residual and recurrent disease depending on type of cholesteatoma, extent of the disease, type of surgery and contalateral ear status was assessed.
  
  
  RESULTS
  Otorrhea and hearing loos are the most common clinical symptoms observed in 90% and 59% children. 70% of treated children had otitis media with effusion and/or its sequel in contralateral ear. 60% of acquired cholesteatomas were classified as S3 and S4 extension during surgery with ossicular destruction in 46% of attic cholestatoma. 75% operated ears had a signs of mucosa inflammation during surgery. Residual cholesteatoma was observed in 38.5% ears with attic cholesteatoma and in 25% with pars tensa I cholesteatoma.
  
  
  CONCLUSIONS
  Acquired cholesteatoma in young children are diagnosed in the advanced stages with ossicular chain destruction. High rate of recidivism after surgery, particularly in attic cholesteatomas is observed. Most of operated ears have symptoms of inflammation of middle era mucosa during surgery and otitis media with effusion in contralateral ear and because of that need long-term follow up and constant observation.
authors.affiliation: Klinika Otolaryngologii Dzieciecej UM w Białymstoku. boskot@umwb.edu.pl
authors.forename: Bozena
authors.initials: B
authors.lastname: Skotnicka
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Hassmann-Poznańska
mesh_terms: D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D004424:Ear Canal / Q000601:surgery*; D004427:Ear Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D004429:Ear Ossicles / Q000473:pathology; D004432:Ear, Middle / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010033:Otitis Media / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011044:Poland / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014433:Tympanoplasty / Q000379:methods