title: The Bony Obliteration Tympanoplasty in Pediatric Cholesteatoma: Long-term Safety and Hygienic Results.
abstract: OBJECTIVE
  To present the safety and hygienic results of a 5-year longitudinal study in a pediatric population undergoing surgery for extensive cholesteatoma using a canal wall up approach with bony obliteration of the mastoid and epitympanic space.
  
  
  METHODS
  Retrospective consecutive study.
  
  
  METHODS
  Thirty-three children (≤18 yr) undergoing surgery for cholesteatoma (34 ears) between 1997 and 2009.
  
  
  METHODS
  Therapeutic.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  1) Residual and recurrent cholesteatoma rates at 5-year postsurgery, 2) postoperative waterproofing and hygienic status of the ear, and 3) required operation rate to achieve the safety and hygienic goals.
  
  
  RESULTS
  At 5 years no patients were lost in follow-up. This consecutive series design is rare in chronical otitis media treatment reporting. The standard residual rate at 5 years was 5.8%, representing two residual cholesteatomas in the middle ear. The standard recurrence rate at 5 years was 2.9%, representing one recurrent cholesteatoma. At 5-year follow-up all ears were free of otorrhea and waterproof and all external ear canals were patent and self-cleaning. The operation rate to reach this safety and hygienic status was 1.5 operations per ear at 5-year follow-up.
  
  
  CONCLUSIONS
  The use of a canal wall up approach with obliteration of the mastoid cavity and epitympanic space to surgically treat cholesteatoma in children results in low residual and recurrence rates and a high rate of trouble-free ears in the long term.
authors.affiliation: *European Institute for Otorhinolaryngology-Head and Neck Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, Sint-Augustinus Hospital †Department of Radiology, Sint-Augustinus Hospital, Antwerp ‡Department of Radiology, Sint-Jan Hospital, Bruges, Belgium §Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Centre, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors.forename: Joost J S
authors.initials: JJ
authors.lastname: van Dinther
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Vercruysse
authors.forename: Sophie
authors.initials: S
authors.lastname: Camp
authors.forename: Bert
authors.initials: B
authors.lastname: De Foer
authors.forename: Jan
authors.initials: J
authors.lastname: Casselman
authors.forename: Thomas
authors.initials: T
authors.lastname: Somers
authors.forename: Andrzej
authors.initials: A
authors.lastname: Zarowski
authors.forename: Cor W R J
authors.initials: CW
authors.lastname: Cremers
authors.forename: Erwin
authors.initials: E
authors.lastname: Offeciers
mesh_terms: D000293:Adolescent; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D002908:Chronic Disease; D004424:Ear Canal; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008416:Mastoid / Q000601:surgery*; D010033:Otitis Media; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D014433:Tympanoplasty / Q000379:methods*