Treatment Outcomes in Pediatric Patients with Acquired Cholesteatoma

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  • 当科における小児後天性真珠腫の治療成績
  • トウ カ ニ オケル ショウニ コウテンセイ シンジュ シュ ノ チリョウ セイセキ

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<p>Acquired cholesteatoma is often advanced even at diagnosis in children and recurs more frequently than in adults. Complete removal of a cholesteatoma without compromising on hearing improvement is important. We retrospectively evaluated the data of 25 children (26 ears, 2–15 years) with acquired cholesteatoma who had undergone tympanoplasty at our department between July 2010 and November 2021. The extent of cholesteatoma, surgical strategies adopted, residual cholesteatoma rate, recurrence rate, and hearing improvement success rate were analyzed. The extent of cholesteatoma was classified into stages according to the Classification and Staging of cholesteatoma proposed by the Japan Otological Society in 2010. One ear was classified as stage I, and the remaining 25 as stage II or III. A canal wall-down mastoidectomy with canal reconstruction using auricular cartilage was performed for ears with stage II/III disease. Staged tympanoplasty was selected for 23 of the 26 ears. Residual cholesteatoma was observed in 10 of the 23 ears treated by staged tympanoplasty at the second operation. The recurrence rate was 15.4% (4/26), including three cases of residual cholesteatoma and one case of retraction cholesteatoma. The overall hearing improvement success rate was 70% (14/20), according to the criteria of the Otological Society of Japan (2010). These results indicate the usefulness of staged tympanoplasty and auricular cartilage reconstruction for minimizing the risk of residual cholesteatoma and retraction cholesteatoma.</p>

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