Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-23T03:17:52.908Z Has data issue: false hasContentIssue false

Surgery for acquired cholesteatoma in children: long-term results and recurrence of cholesteatoma

Published online by Cambridge University Press:  29 June 2007

Sven-Eric Stangerup*
Affiliation:
Department of Otolaryngology, Gentofte University Hospital, Hellerup, Denmark.
Dominika Drozdziewicz
Affiliation:
Department of Otolaryngology, Gentofte University Hospital, Hellerup, Denmark.
Mirko Tos
Affiliation:
Department of Otolaryngology, Gentofte University Hospital, Hellerup, Denmark.
Franco Trabalzini
Affiliation:
Department of Otolaryngology, Gentofte University Hospital, Hellerup, Denmark.
*
Address for correspondence: Sven-Eric Stangerup, M.D., ENT Department, Gentofte University Hospital, Niels Andersens vej 65, DK-2900 Hellerup, Denmark. Fax: +45 48 24 76 13

Abstract

The aim of the study was to evaluate the long-term results after surgery for acquired cholesteatoma in children and to contribute to the search for predictors of recurrence. During a 15-year period, 114 children underwent surgery. The patients were re-evaluated with a median observation time of 5.8 years. At the last re-evaluation 85 per cent of the ears were dry with an intact drum. Recurrence of cholesteatoma developed in 27 ears. The cumulated total recurrence rate was 24 per cent using the incidence rate calculation, applying Kaplan-Meier survival analysis the corresponding recurrence was 33 per cent. Recurrent disease occurred significantly more frequently in children younger than eight years, with a negative pre-operative Valsalva, with ossicular resorption and with large cholesteatomas. In conclusion, young children with poor Eustachian tube function and a large cholesteatoma with erosion of the ossicular chain, are at special risk of recurrence and should be observed for several years after surgery.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1998

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.)

References

Brown, J. S. (1982) A ten year statistical follow-up of 1142 consecutive cases of cholesteatoma: The closed vs the open technique. Laryngoscope 92: 390396.CrossRefGoogle Scholar
Edelstein, D. R., Parisier, S. C. (1989) Surgical technique and recidivism in cholesteatoma. Otolaryngologic Clinics of North America 22: 10291040.CrossRefGoogle ScholarPubMed
Gyo, K., Hinohira, Y., Sasaki, Y., Yanagihara, N. (1996) Residue of middle ear cholesteatoma after intact canal wall tympanoplasty: Surgical findings at one year. Annals of Otology, Rhinology and Laryngology 105: 615619.CrossRefGoogle ScholarPubMed
Jansen, C. (1978) Cholesteatoma in children. Clinical Otolarvngology 3: 349352.CrossRefGoogle ScholarPubMed
Moeschberger, M. L., Klein, J. P. (1995) Statistical methods for dependent competing risks. Lifetime Data Anal 1(2): 195204.CrossRefGoogle ScholarPubMed
Parisier, S. C., Hanson, M. B., Han, J. C., Cohen, A. J., Selkin, B. A. (1996) Paediatric cholesteatoma: An individualised, single-stage approach. Otolaryngology – Head and Neck Surgery 115: 107114.CrossRefGoogle ScholarPubMed
Rosenfefd, R. M., Moura, R. L., Bluestone, C. D. (1992) Predictors of residual–recurrent cholesteatoma in children. Archives of Otolaryngology – Head and Neck Surgery 118: 384391.CrossRefGoogle Scholar
Sade, J. (1993) Treatment of cholesteatoma and retraction pockets. European Archives of Otorhinolaryngology 250(4): 193199.CrossRefGoogle ScholarPubMed
Schuring, A. G., Lippy, W. H., River, F. M., Schuring, L. T. (1990) Staging for cholesteatoma in the child, adolescent and adult. Annals of Otology, Rhinology and Laryngology 99: 256260.CrossRefGoogle ScholarPubMed
Smyth, G. D. L. (1976) Postoperative cholesteatoma in combined approach tympanoplasty. Journal of Laryngology and Otology 90: 597621.CrossRefGoogle ScholarPubMed
Smyth, G. D. L., Fisch, U. (1985) Panel discussion on cholesteatoma management at the seventh Shambaugh- Shea International Work-shop on Otology, March 1–4, 1984. American Journal of Otology 6: 2627.Google Scholar
Tos, M. (1982) Modification of combined-approach tympanoplasty in attic cholesteatoma. Archives of Otolaryngology 108: 772778.CrossRefGoogle ScholarPubMed
Tos, M., Lau, T. (1989) Late results of surgery in different cholesteatoma types. Oto-Rhino-Laryngology 51: 3349.Google ScholarPubMed
Vartiainen, E. (1995) Factors associated with recurrence of cholesteatoma. Journal of Laryngology and Otology 109: 590592.CrossRefGoogle ScholarPubMed