alexa Aural acquired cholesteatoma in children: surgical findings, recurrence and functional results.
Surgery

Surgery

Surgery: Current Research

Author(s): De Corso E, Marchese MR, Scarano E, Paludetti G

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Abstract OBJECTIVE: This study was designed to compare clinical features, surgical findings and treatment results from children and adults affected by aural acquired cholesteatoma. METHODS: a retrospective review of 60 children (Group I: mean age 8.8 years, range 3-16 years) and 308 adults (Group II: mean age 45.4 years, range 18-81 years) with aural acquired cholesteatoma who underwent surgery from January 1992 to December 2002, was performed with a follow-up of 5 years. All patients were submitted to single-staged canal wall down tympanoplasty. Variables analysed were otoscopic features, extent of cholesteatoma, surgical findings and the rate of recidivism. RESULTS: The pathologic changes in the tympanic membrane were no different in the two groups. According to Stangerup et al. 40 cases (66.6\%) of children were classified as stage III or more, with a significant higher incidence compared to adults (152 cases; 49.3\%). Analysis of the ossicular chain state showed, in group I, a significant higher incidence of eroded or absent incus (76.6\% versus 61.68\%) and malleus (76.6\% versus 56.48\%), if compared to adults. Children, therefore, had a significantly higher risk of recurrence with a rate of 26.6\% in Group I and 6.81\% in group II. After surgery the mean gain measured in children group, was 11 dB and 13 dB in adults. CONCLUSION: In our study we found that the behaviour of cholesteatoma in children appears more aggressive than in adults. In fact, we found a greater extension of the cholesteatoma, a worse state of the ossicular chain and a higher incidence of recurrence. Therefore, we obtained acceptable hearing results both in children and in adults. This article was published in Int J Pediatr Otorhinolaryngol and referenced in Surgery: Current Research

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