[Cholesteatoma and chronic tubal middle ear infection in children. A 10 year overview].

Over a 10-year period we observed 99 cholesteatomas. In 62% the cholesteatomas lay in the epitympanum, in 18% they lay behind an intact tympanic membrane, and in 18% in the posterior-superior portion of the pars tensa. There were 2 cases of iatrogenic cholesteatoma following insertion of ventilation tubes. In the same period we saw 1229 children suffering from chronic serous otitis media (SOM). A total of 1918 ventilation tubes were inserted in 856 children with SOM, so that the incidence of iatrogenic cholesteatomas is extremely low at 0.1%. Our findings indicate that cholesteatomas in the posterior-superior portion of the pars tensa are more often caused by disturbed ventilation due to SOM than are epitympanic cholesteatomas. Furthermore myringotomy and ventilation tube insertion is not only a means of treating SOM, but it can also reveal a hidden cholesteatoma. Long-term follow-up of children treated for SOM is necessary in order to recognise cholesteatomas and adhesive processes at an early stage.