A scheme for challenging cholesteatoma in children

In order to secure both long-lasting carefree ears and hearing-preservation/restoration, the best method to apply is the closed-method tympanoplasty, especially for cholesteatomatous otitis media in children. We agree with this method, in spite of the high percentages of postoperative residual cholesteatoma in children. Until a better way of irradicating cholesteatoma becomes available, either staged operations or periodical check-ups for many years are mandatory. While postoperative attic retraction/cholesteatoma formation seems to be preventable in most cases, the rate of residual cholesteatoma is very high in our data and in other reports. Looking for a reason, the differences between the cholesteatoma in children and those in adults are to be investigated in macro-, micro- and ultramicroscopic observations. In addition, basic rather than clinical studies on cholesteatoma in children are requested.