| Abstract | dc.description.abstract | Objectives: To determine the incidence of severe atelectatic otitis media and acquired cholesteatoma
(AC) in children treated for congenital cholesteatoma (CC).
Methods: Retrospective chart review of 15 children who underwent primary surgery for CC over a 15
year period by a single surgeon.
Results: The mean postoperative follow up was 3.1 years. Significant tympanic retraction occurred in 6
children, included a retraction pocket that required T-tube insertion (3), and AC requiring
tympanomastoid surgery (3). There was no complication related to retraction pocket in 9 children
however 2 developed residual disease.
In comparing the two groups, those with and without subsequent significant tympanic retraction,
both groups had similar gender, age, extent of CC (median Potsic grade of 2), bone erosion, and surgical
technique. Differenceswere noted in air-bone gap at presentation (PTA 32.4 and 17.25), otitismedia with
effusion in the contralateral ear (3/6 and 1/9), smaller mastoid volume ratio compared with the
contralateral ear (0.74 and 1.21), and longer average timing for second surgery (14.8 months and 8
months).
Conclusions: Acquired middle ear disease, including cholesteatoma, can follow surgical removal of
CC, and long term follow up of all patients is required. Factors at initial evaluation indicative of risk
of AC include a significant air-bone gap, otitis media with effusion in the contralateral ear and a
smaller mastoid cavity ratio. The use of composite grafts at the time of CC surgery should be
considered. Additionally, our findings suggest that the mastoid volume plays a causative role in the
development of AC. | es_CL |
