Late Results of Cholesteatoma Surgery in Children

Czech version

Authors: B. Kohútová-Hartmannová; M. Sičák
Authors‘ workplace: Klinika otorinolaryngológie a chirurgie hlavy a krku, Ústredná vojenská nemocnica SNP, Fakultná nemocnica, Ružomberok
Published in: Otorinolaryngol Foniatr, 59, 2010, No. 1, pp. 10-14.
Category: Original Article

Overview

Introduction:
Cholesteatoma in children is considered more aggressive than in adults. The aim of an otosurgeon is to remove cholesteatoma safely and completely and at the same time to preserve anatomy and physiology of the ear.

Material and methods:
We are evaluating a group of 38 cholesteatomas in the children who were operated at ORLCHHK in Ruzomberok in 1996-2006. The patients have been monitored to show in what extent the eradication of cholesteatoma, audiological results as well as tympanoplasty have been successful.

Results:
By canal wall up (CWU) technique, 29 ears were operated on and canal wall down (CWD) technique was used in 3 ears. 6 ears did not require antrotomy and/or antromastoidectomy and they were resolved by cleaning tympanic sinus and/ or atticus. We detected recurrent cholesteatoma in 17 ears (45 %). We re-operated in 4 cases because of unsatisfactory result of tympanoplasty. 42 % ears were without failure of hearing postoperatively, and decrease aier-bone gap (ABG) to 20 dB was recorded in 21 % ears. We evaluated ABG 25-40 dB in 37 % ears. There have been no records of ABG more than 40 dB postoperatively.

Conclusion:
Nowadays, surgery of cholesteatoma is not only about safety and radical removal of pathological tissue. Functional, minimal invasive surgery is optimal, which enables preservation of most of the original structures and thus it offers the best conditions for reconstruction.

Key words:
cholesteatoma, child, recurrent cholesteatoma, canal wall down, canal wall up, combined approach tympanoplasty.

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