The Bony Obliteration Tympanoplasty in Pediatric Cholesteatoma: Long-term Safety and Hygienic Results.

Abstract

OBJECTIVE:

To present the safety and hygienic results of a 5-year longitudinal study in a pediatric population undergoing surgery for extensive cholesteatoma using a canal wall up approach with bony obliteration of the mastoid and epitympanic space.

STUDY DESIGN:

Retrospective consecutive study.

PATIENTS:

Thirty-three children (≤18 yr) undergoing surgery for cholesteatoma (34 ears) between 1997 and 2009.

INTERVENTIONS:

Therapeutic.

SETTING:

Tertiary referral center.

MAIN OUTCOME MEASURES:

1) Residual and recurrent cholesteatoma rates at 5-year postsurgery, 2) postoperative waterproofing and hygienic status of the ear, and 3) required operation rate to achieve the safety and hygienic goals.

RESULTS:

At 5 years no patients were lost in follow-up. This consecutive series design is rare in chronical otitis media treatment reporting. The standard residual rate at 5 years was 5.8%, representing two residual cholesteatomas in the middle ear. The standard recurrence rate at 5 years was 2.9%, representing one recurrent cholesteatoma. At 5-year follow-up all ears were free of otorrhea and waterproof and all external ear canals were patent and self-cleaning. The operation rate to reach this safety and hygienic status was 1.5 operations per ear at 5-year follow-up.

CONCLUSION:

The use of a canal wall up approach with obliteration of the mastoid cavity and epitympanic space to surgically treat cholesteatoma in children results in low residual and recurrence rates and a high rate of trouble-free ears in the long term.

• Authors: Joost J S van Dinther, Jean-Philippe Vercruysse, Sophie Camp, Bert De Foer, Jan Casselman, Thomas Somers, Andrzej Zarowski, Cor W R J Cremers, Erwin Offeciers
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 36 Issue 9 Pg. 1504-9 (Sep 2015) ISSN: 1537-4505 [Electronic] United States
• PMID: 26375973 (Publication Type: Journal Article)

Topics

• Adolescent
• Child
• Cholesteatoma, Middle Ear (surgery)
• Chronic Disease
• Ear Canal
• Ear, Middle (surgery)
• Female
• Humans
• Longitudinal Studies
• Male
• Mastoid (surgery)
• Otitis Media
• Postoperative Period
• Recurrence
• Retrospective Studies
• Tympanoplasty (methods)