title: Acquired cholesteatoma in children: strategies and medium-term results.
abstract: OBJECTIVE
  To assess paediatric cholesteatoma surgical management strategies, residual disease and recurrence rates and especially the medium-term auditory impact.
  
  
  METHODS
  Retrospective study of 22 cases of acquired middle ear cholesteatoma selected from a series of 77 children under the age of 16 operated for cholesteatoma between 1st January 2000 and 31st December 2003 on the basis of the following criteria: first-line surgical management with postoperative follow-up greater than four years. Surgical strategies, preoperative and postoperative (at 1 year and at the final visit) audiograms and residual disease and recurrence rates were analysed.
  
  
  RESULTS
  A canal wall up tympanoplasty was performed in 82% of cases as first-line procedure and a canal wall down tympanoplasty was performed in 32% of cases. Residual cholesteatoma was observed in 9% of cases and recurrent disease was observed in 18% of cases. The mean preoperative hearing loss was 26dB with an air-bone gap of 23dB with values of 26dB and 20dB respectively at the end of follow-up.
  
  
  CONCLUSIONS
  The majority of children were operated by two-stage canal wall up tympanoplasty. Long-term hearing results remained stable and close to preoperative values. The recurrence rate (residual disease and relapse) was low (27%), as reported in the literature.
authors.affiliation: Service d'ORL-CCF, CHU Charles-Nicolle, Rouen cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Drahy
authors.forename: A
authors.initials: A
authors.lastname: De Barros
authors.forename: Y
authors.initials: Y
authors.lastname: Lerosey
authors.forename: O
authors.initials: O
authors.lastname: Choussy
authors.forename: D
authors.initials: D
authors.lastname: Dehesdin
authors.forename: J-P
authors.initials: JP
authors.lastname: Marie
mesh_terms: D000293:Adolescent; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000473:pathology / Q000601:surgery*; D004424:Ear Canal / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods