Extensive acquired cholesteatoma in children

When the penny drops

Craig W. Semple, Murali Mahadevan, Robert G. Berkowitz*

*Corresponding author for this work

    Research output: Contribution to journalReview article

    6 Citations (Scopus)

    Abstract

    Objectives: To determine the factors associated with the diagnosis of acquired cholesteatoma (AC) in children, we performed a retrospective chart review at a tertiary care center. Methods: We reviewed children with a diagnosis of AC that extended beyond the mesotympanum in the presence of a nonintact tympanic membrane who underwent surgical treatment over a 14-year period. Results: There were 116 children (78 male, 38 female) between 3 and 18 years of age (mean, 9.5 years). Their average period of management in a specialist otolaryngology clinic before the diagnosis of cholesteatoma was made was 3.2 years, and 68% of the children had previously undergone insertion of tympanostomy tubes. Symptoms and signs included chronic otorrhea (59%), recurrent acute otitis media (58%), and conductive hearing loss (51%). The diagnosis of AC was eventually made after office otoscopy (26%), temporal bone computed tomography (24%), or examination under anesthesia (17%). In 33% of children, the diagnosis was made only after surgical exploration of the middle ear and mastoid. Conclusions: Our data underscore the importance of maintaining a high index of suspicion for AC in managing children with long-standing otologic symptoms, and considering otomicroscopy, computed tomographic scanning, or tympanomastoid exploration if medical treatment fails.

    Original languageEnglish
    Pages (from-to)539-542
    Number of pages4
    JournalAnnals of Otology, Rhinology and Laryngology
    Volume114
    Issue number7
    Publication statusPublished - Jul 2005

    Keywords

    • Acquired cholesteatoma
    • Diagnosis
    • Otitis media
    • Otorrhea

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