Problems in diagnosis and treatment of cholesteatoma in children.
Our clinical study includes 56 cases of cholesteatoma in children aged 3-14 years, treated in a 6-year period. Cholesteatoma was localized in attic (6 cases), in middle ear (6 cases), in attic plus middle ear (16 cases) and in attic + middle ear + mastoid (28 cases or 50% of the total number). In the surgical treatment combined approach tympanoplasty (intact canal wall technique) was used in 76.8%, radical tympanomastoidectomy in 16.1%, and other techniques in 7.1%. Intact ossicular chain was found in 25%. Reconstruction of the ossicular chain (including autograft, homograft and allograft material) was done in 59%, and the remaining 16% were treated by classic radical surgery. Hearing results: unchanged, 48%; improved, 45%; slightly worsened, 7%; and no dead ear. Recurrency in 31% is considerably higher as compared to 15% in adults found in another comparable study by us.