Cholesteatoma of the middle ear in children may cause
hypoacusis. Early diagnosis and optimal treatment is neccessary for good functional effect. We present 57 children (58 ears) with
cholesteatoma treated in ENT Department of Medical University in Gdańsk in 1991-2002. The age of patients ranged between 3 and 16 years, the most common 11-15 years. In 52 (89.6%) cases acquired
cholesteatoma and in 6 (10.4%)
congenital cholesteatoma was diagnosed. Epitympanal
cholesteatoma was found in 32 children (55.1%) whereas in posterior part of tympanic cavity--in 20 children (34.5%). In 6 cases (10.4%) intact tympanic membrane was found. Mean air-bone gap in acquired
cholesteatoma before treatment was 18.7 dB,
after treatment 15.7 dB. In
congenital cholesteatoma mean air-bone gap before treatment was 13.6 dB,
after treatment 14 dB. The most frequent symptom was
hearing loss (98.3%) and purulent otorrhea (85.4%). Positive bacteriological culture was obtained in 43.1% of the cases. X-ray revealed sclero-pneumatic mastoid in 26 (34.5%) cases, sclerotic in 25 (43.1%) and pneumatic mastoid in 7 (12.1%) cases. Intracranial complications were found in 2 cases, intratemporal in 2 cases and extracranial complication in 1 case. Radical surgery was performed in 23 cases (39.7%) and in each case, which required reoperation,
modified radical mastoidectomy in 20 cases (34.4%), in another 15 children (25.9%)
tympanoplasty was done. The most frequent failure was purulent otorrhea in 21 (36.2%) cases. Reoperation in
cholesteatoma recurrence was performed in 17 children (29.3%). Improvement or the same as preoperatively hearing level was obtained in 35 (60.3%) ears,
hearing loss was revealed in 23 (39.7%) ears. Treatment of temporal bone
cholesteatoma in children is difficult due to silent beginning, aggressive growth and frequent recurrence. The best treatment results in children
cholesteatoma are obtained in early clinical stage and with open
tympanoplasty procedure.