title: Evaluation of second look procedures for pediatric cholesteatomas.
abstract: OBJECTIVE
  This study aims to identify factors that may help predict recurrence, the need for second-look operations, and other outcomes in the pediatric population.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  Five hundred and seventeen ears in 493 patients underwent primary acquired cholesteatoma resection over a 37-year period. Demographic (age, sex, and other medical conditions), cholesteatoma laterality, presence of perforation or otorrhea on otoscopic exam, preoperative and most recent audiologic data, and detailed intraoperative data were collected.
  
  
  RESULTS
  Overall, 47.2% of patients underwent second-look operations, with 48.0% having recurrent cholesteatoma visualized with attic recurrence being the most common location. In total, 22.7% of all patients in this study had recurrent disease. Factors at initial operation associated with a statistically significant increased risk of recurrence included cholesteatoma in the sinus tympani (odds ratio = 2.09; 95% confidence interval, 1.36-3.22) and incus destruction (1.65; 1.01-2.71).
  
  
  CONCLUSIONS
  The authors have successfully identified multiple factors at the time of initial operation that can have significant postoperative implications.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Theodore R
authors.initials: TR
authors.lastname: McRackan
authors.forename: Walid M
authors.initials: WM
authors.lastname: Abdellatif
authors.forename: George B
authors.initials: GB
authors.lastname: Wanna
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rivas
authors.forename: Nikita
authors.initials: N
authors.lastname: Gupta
authors.forename: Mary S
authors.initials: MS
authors.lastname: Dietrich
authors.forename: David S
authors.initials: DS
authors.lastname: Haynes
mesh_terms: D000293:Adolescent; D001309:Auditory Threshold; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008416:Mastoid / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D014433:Tympanoplasty