Epitympanoplasty with Mastoid Obliteration Technique in Children with Cholesteatoma

Kang, Myung Koo; Park, Dong Eun; Park, Byung Gun; Bae, Woo Yong; Lee, Tae Hoon

Abstract

BACKGROUND AND OBJECTIVES
Cholesteatoma in children has a more aggressive growth pattern than observedin adults and often involves the entire mastoid and tympanic cavity, which necessitates early surgical treatment. The rapid tissue growth, the greater degree of infection and inflammation brought on by the Eustachian tube, and well pneumatized mastoid are the major contributing factors for cholesteatoma being so extensive in children. In this study, we evaluated the result of epitympanoplasty and mastoid obliteration in cholesteatoma of children. SUBJECTS AND METHOD: The operation was performed in 28 children patients under the age of 15 from May 11, 1995 to August 13, 2003. They were 3 congenital and 25 acquired cholesteatoma cases, which were accompanied by 4 cases of adhesive otitis media, 1 case of external auditory canal cholesteatoma, and 1 case of congential aural atresia that developed after two operations of canaloplasty. RESULTS: Of the 28 cases, 6 underwent one-staged operation and 8 underwent second-look operations, respectively. In 3 of the 8 cases that underwent second look operation, there was residual cholesteatoma in the tympanic cavity, and cholesteatoma was removed. After operation, there was no recurrent cholesteatoma. Among the 13 cases of ossiculoplasty, 9 could have the test of pure tone audiogram, and 5 cases could preserve postoperative air-bone gap within 30 dB. CONCLUSION: It is expected that epitympanoplasty with the mastoid obliteration technique reduces the air-burden of E-tube in children of cholesteatoma, and the technique probably can prevent the formation of retraction pocket and recurrence of cholesteatoma.