Learning Objectives: Management of pediatric cholesteatoma and the long term outcomes of canal wall up mastoidectomy.

The objectiveof this study is to report the Gruppo Otologico experience in the surgical treatment of paediatric cholesteatoma. This is a retrospective study wherein 572 charts of young patients who underwent surgery between 1983 and 2015 were analysed. 46 patients had bilateral disease and the average age was 10.6 years old. The extension of cholesteatoma was defined using Sanna and Zini's cholesteatoma classification. The most commonly surgical procedure used in children were Canal Wall Up and a Canal Wall Down tympanoplasty. Canal Wall Up Tympanoplasty (CWU) was performed in 263 patients, while, Canal Wall Down Tympanoplasty (CWD) that includes Modified Bondy Technique (BT) and Radical Mastoidectomy (RM), was used in 258 patients. There were more numbers of revision surgeries in CWU (34%) than CWD (10%) tympanoplasty. In all surgeries put together, we had an improvement of hearing of a mean of 8.5 dB HL. The mean follow-up was 10 years. In conclusion, the technique of choice for pediatric cholesteatoma is CWU tympanoplasty. However, the use of a CWD approach to surgically treat extensive cholesteatoma in children results in a low recurrence rate with a high rate of trouble-free ear in the long term.