Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-23T05:44:25.406Z Has data issue: false hasContentIssue false
  • English
  • Français

Cholesteatoma in children and adults: are there really any differences?

Published online by Cambridge University Press:  18 June 2018

R Jackson ,
A B Addison  and
P R Prinsley
R Jackson*
Affiliation:
Department of ENT, James Paget University Hospital, Great Yarmouth, UK
A B Addison
Affiliation:
Department of ENT, West Suffolk Hospital, Bury Saint Edmunds, UK
P R Prinsley
Affiliation:
Department of ENT, James Paget University Hospital, Great Yarmouth, UK
*
Author for correspondence: Mr Richard Jackson, Department of ENT, James Paget University Hospital, Lowestoft Road, Gorleston-on-Sea, Great Yarmouth NR31 6LA, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cholesteatoma is widely considered to be more aggressive in children than adults, yet few studies have directly compared the operative findings and surgical outcomes between these two groups. This study aimed to assess differences between childhood and adult cholesteatoma.

Methods

The operative caseload of a single consultant surgeon was reviewed between January 2006 and May 2017 using the online Common Otology Audit database. Extracted data were categorised according to patient age (children, aged below 16 years, and adults, aged 16 years or over) and compared.

Results

This study included data from 71 operations on children and 281 operations on adults, performed for cholesteatoma. Childhood cholesteatoma demonstrated significantly more extension (into the sinus tympani, mastoid antrum and mastoid air cells) and ossicular erosion (of the malleus, incus and stapes superstructure) compared to adults. No significant differences were seen in revision rates, post-operative complications or hearing gain.

Conclusion

Childhood cholesteatoma was more extensive and destructive compared to adults, representing a more aggressive disease in this cohort.

Keywords

CholesteatomaChildrenAdultRevision SurgeryPost-operative complicationsTreatment Outcome
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 7 , July 2018 , pp. 575 - 578
Copyright
Copyright © JLO (1984) Limited, 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr R Jackson takes responsibility for the integrity of the content of the paper

References

1Maniu, A, Harabagiu, O, Perde Schrepler, M, Cătană, A, Fănuţă, B, Mogoantă, CA. Molecular biology of cholesteatoma. Rom J Morphol Embryol 2014;55:7–13Google Scholar
2Yung, M, Tono, T, Olszewska, E, Yamamoto, Y, Sudhoff, H, Sakagami, M et al. EAONO/JOS Joint Consensus Statements on the Definitions, Classification and Staging of Middle Ear Cholesteatoma. J Int Adv Otol 2017;13:1–8Google Scholar
3Dodson, EE, Hashisaki, GT, Hobgood, TC, Lambert, PR. Intact canal wall mastoidectomy with tympanoplasty for cholesteatoma in children. Laryngoscope 1998;108:977–83Google Scholar
4Zarandy, MM, Rutka, J. Cholesteatoma and its complications. In: Diseases of the Inner Ear: A Clinical, Radiologic, and Pathologic Atlas. Berlin, Heidelberg: Springer, 2010;9–17Google Scholar
5Nevoux, J, Lenoir, M, Roger, G, Denoyelle, F, Ducou Le Pointe, H, Garabédian, E-N. Childhood cholesteatoma. Eur Ann Otorhinolaryngol Head Neck Dis 2010;127:143–50Google Scholar
6Persaud, R, Hajioff, D, Trinidade, A, Khemani, S, Bhattacharyya, MN, Papadimitriou, N et al. Evidence-based review of aetiopathogenic theories of congenital and acquired cholesteatoma. J Laryngol Otol 2007;121:1013–19Google Scholar
7Tos, M. Incidence, etiology and pathogenesis of cholesteatoma in children. Adv Otorhinolaryngol 1988;40:110–17Google Scholar
8Kuo, C-L, Shiao, A-S, Yung, M, Sakagami, M, Sudhoff, H, Wang, C-H et al. Updates and knowledge gaps in cholesteatoma research. Biomed Res Int 2015;2015:1–17Google Scholar
9Olszewska, E, Wagner, M, Bernal-Sprekelsen, M, Ebmeyer, J, Dazert, S, Hildmann, H et al. Etiopathogenesis of cholesteatoma. Eur Arch Otorhinolaryngol 2004;261:6–24Google Scholar
10Louw, L. Acquired cholesteatoma pathogenesis: stepwise explanations. J Laryngol Otol 2010;124:587–93Google Scholar
11Khalid-Raja, M, Tikka, T, Coulson, C. Cholesteatoma: a disease of the poor (socially deprived)? Eur Arch Otorhinolaryngol 2015;272:2799–805Google Scholar
12Homøe, P, Rosborg, J. Family cluster of cholesteatoma. J Laryngol Otol 2007;121:65–7Google Scholar
13Prinsley, P. Familial cholesteatoma in East Anglia, UK. J Laryngol Otol 2009;123:294–7Google Scholar
14Edelstein, DR, Parisier, SC, Ahuja, GS, Juarbe, C, Chute, P, Wenig, S et al. Cholesteatoma in the pediatric age group. Ann Otol Rhinol Laryngol 1988;97:23–9Google Scholar
15Darrouzet, V, Duclos, JY, Portmann, D, Bebear, JP. Preference for the closed technique in the management of cholesteatoma of the middle ear in children: a retrospective study of 215 consecutive patients treated over 10 years. Am J Otol 2000;21:474–81Google Scholar
16Lynrah, ZA, Bakshi, J, Panda, NK, Khandelwal, NK. Aggressiveness of pediatric cholesteatoma. Do we have an evidence? Indian J Otolaryngol Head Neck Surg 2013;65:264–8Google Scholar
17Mallet, Y, Nouwen, J, Lecomte-Houcke, M, Desaulty, A. Aggressiveness and quantification of epithelial proliferation of middle ear cholesteatoma by MIB1. Laryngoscope 2003;113:328–31Google Scholar
18Dornelles Cde, C, da Costa, SS, Meurer, L, Rosito, LP, da Silva, AR, Alves, SL. Comparison of acquired cholesteatoma between pediatric and adult patients. Eur Arch Otorhinolaryngol 2009;266:1553–61Google Scholar
19Common Otology Audit. In: http://www.ear-audit.net [28 April 2018]Google Scholar
20Visvanathan, V, Kubba, H, Morrissey, MS. Cholesteatoma surgery in children: 10-year retrospective review. J Laryngol Otol 2012;126:450–3Google Scholar
21Glasscock, ME, Dickins, JR, Wiet, R. Cholesteatoma in children. Laryngoscope 1981;91:1743–53Google Scholar
22Elrashidi, AM. Cholesteatoma in children. Eur Arch Otorhinolaryngol 1992;249:389–92Google Scholar
23Sadé, J, Fuchs, C. Cholesteatoma: ossicular destruction in adults and children. J Laryngol Otol 1994;108:541–4Google Scholar
24Sadé, J, Shatz, A. Cholesteatoma in children. J Laryngol Otol 1988;102:1003–6Google Scholar
25Preciado, D. Biology of cholesteatoma: special considerations in pediatric patients. Int J Pediatr Otorhinolaryngol 2012;76:319–21Google Scholar