TITLE:
Clinico-Investigational Profile and Surgical Outcomes of Pediatric Cholesteatoma: A Case Series
AUTHORS:
Paramita Saha, Irine A. Thomas, Rahul Kunkulol
KEYWORDS:
Pediatric, Cholesteatoma, Children, Canal Wall Down
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.13 No.6,
October
9,
2024
ABSTRACT: Pediatric cholesteatoma causes extensive destruction within the middle ear and adjacent structures. Despite advancements in surgical techniques, the management of pediatric cholesteatoma remains controversial due to the varied presentations and its rapid progression. This study aims to evaluate the presentation of symptoms, otoscopic findings, surgical outcomes, and functional results in a series of pediatric cholesteatoma patients at our institution. A total of 18 patients, aged 5 - 14 years, underwent canal wall down (CWD) or intact canal wall (ICW) surgery based on the extent of disease as assessed intraoperatively. The study focused on the sites involved by cholesteatoma, the surgical challenges encountered, and the techniques employed. Outcomes measured included the incidence of residual and recurrent cholesteatoma, as well as hearing function at follow-up. Our results indicated a 69% improvement in the air-bone gap (ABG) among patients, with residual perforation observed in 4% of cases and no recurrences during the follow-up period. The increased selection of the CWD technique correlated with the extensive nature of the disease presentation. This study underscores the necessity for individualized treatment plans in pediatric cholesteatoma management, considering the aggressive nature of the disease and the need for a balance between eradication and hearing preservation.