Brazilian journal of otorhinolaryngology · 2025
Bilateral middle ear cholesteatoma in children: A single-center retrospective study.
СтатьяНазвание и аннотация: Перевод в очереди
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Wang Xiaoxu, Guo Lining, Tian Enxia, Chen Min, Liu Wei, Ni Xin, Zhang Jie
Аннотация
OBJECTIVES: To analyze the clinical characteristics of bilateral cholesteatoma in children and summarize the clinical treatment pathway.
METHODS: In this retrospective cohort study, we analyzed the records of children with bilateral middle ear cholesteatoma who underwent surgery in our department between 2016 and 2023. The clinical characteristics, treatment and prognosis were analyzed.
RESULTS: The records of 12-children (24-ears, 4girls and 8-boys) were reviewed. The mean age was 6.5 ± 2.6-years. Four children had Congenital Cholesteatoma (CC) in one ear and Acquired Cholesteatoma (AC) in the other ear and 8-children had AC in both ears. The onset time and lesion degree of the bilateral ears are different. Nine children had maxillary developmental deformities (75%). One child underwent simultaneous binaural surgery, and 11 underwent staged surgery, with a median interval of 3-months between surgeries. The follow-up period was 4.28 ± 2.58-years. No postoperative complications. Six children (7-ears) underwent revision surgery due to recurrence. There was no significant difference in hearing results between pure-tone average of preoperative (41.23 ± 16.50 dB) and postoperative (37.79 ± 14.42 dB) (p = 0.291, t = 1.082). There was no significant difference in postoperative hearing between CC and AC (p = 0.355, F = 4.268). There were significant differences in postoperation hearing among different surgical methods (p = 0.006, H = 12.630). There were significant differences in postoperation hearing among different ossiculoplasty methods (p = 0.001, H = 17.590).
CONCLUSIONS: In our cohort, the average age at diagnosis of bilateral cholesteatoma in children was notably young, with a high proportion presenting concurrent cleft palate deformities. Staged surgical intervention prioritizing the more severely affected ear was adopted for bilateral cases. Furthermore, long-term follow-up is necessary due to the observed high recurrence rate in this population. A management flowchart has been proposed based on our therapeutic experience.
LEVEL OF EVIDENCE: Level 4.
METHODS: In this retrospective cohort study, we analyzed the records of children with bilateral middle ear cholesteatoma who underwent surgery in our department between 2016 and 2023. The clinical characteristics, treatment and prognosis were analyzed.
RESULTS: The records of 12-children (24-ears, 4girls and 8-boys) were reviewed. The mean age was 6.5 ± 2.6-years. Four children had Congenital Cholesteatoma (CC) in one ear and Acquired Cholesteatoma (AC) in the other ear and 8-children had AC in both ears. The onset time and lesion degree of the bilateral ears are different. Nine children had maxillary developmental deformities (75%). One child underwent simultaneous binaural surgery, and 11 underwent staged surgery, with a median interval of 3-months between surgeries. The follow-up period was 4.28 ± 2.58-years. No postoperative complications. Six children (7-ears) underwent revision surgery due to recurrence. There was no significant difference in hearing results between pure-tone average of preoperative (41.23 ± 16.50 dB) and postoperative (37.79 ± 14.42 dB) (p = 0.291, t = 1.082). There was no significant difference in postoperative hearing between CC and AC (p = 0.355, F = 4.268). There were significant differences in postoperation hearing among different surgical methods (p = 0.006, H = 12.630). There were significant differences in postoperation hearing among different ossiculoplasty methods (p = 0.001, H = 17.590).
CONCLUSIONS: In our cohort, the average age at diagnosis of bilateral cholesteatoma in children was notably young, with a high proportion presenting concurrent cleft palate deformities. Staged surgical intervention prioritizing the more severely affected ear was adopted for bilateral cases. Furthermore, long-term follow-up is necessary due to the observed high recurrence rate in this population. A management flowchart has been proposed based on our therapeutic experience.
LEVEL OF EVIDENCE: Level 4.