Cholesteatoma in Children: An Overview

Abstract

Objectives:

Describe in children: (1) cholesteatoma growth patterns; (2) conductive hearing loss severity; (3) contralateral ear (CLE) findings.

Methods:

Cross-sectional study. Videotoscopies of 129 pediatric patients at a tertiary care hospital were analyzed for cholesteatoma growth patterns, air-bone gap, and CLE otoscopic findings. Data were compared with the chi-squared test and analyzed using SPSS.

Results:

The mean patient age was 12.4 ± 4.36 years. The cholesteatoma growth patterns were anterior epitympanic cholesteatomas (5.4%), posterior epitympanic (21.7%), posterior mesotympanic (43.4%), 2 routes pattern (17.1%), and undetermined (12.4%). The pure tone average air-bone gap (PTA-ABG) was ≤20 dB in 8.7% of patients, between 20 to 40 dB in 43.4% of patients, and ≥40 dB in 47.9%. The CLE was normal in 34.9% of patients and had moderate or severe tympanic membrane (TM) retractions in 46.5%, TM perforation in 7.8%, and cholesteatoma in 10.9% of patients. The CLE disease prevalence was similar between the groups, except in anterior epitympanic group, which had normal CLE (P = .004).

Conclusions:

Posterior mesotympanic cholesteatomas were the most prevalent in the study population. Most patients had a PTA-ABG greater than 20 dB, and the most prevalent CLE abnormalities were moderate or severe TM retraction and cholesteatoma. The CLE of patients diagnosed with anterior epitympanic cholesteatoma were normal, suggesting a probable congenital origin.