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Updated: Jul 10, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
A 5-year observational study of the outcome in pediatric cholesteatoma surgery
Matthew Yung1, Nicola L Jacobsen, Sarah L Vowler
1Department of Otolaryngology, The Ipswich Hospital NHS Trust, Heath Rd, Ipswich, Suffolk, IP5 4PD, UK. matthewyung@btconnect.com
Insights
Pediatric cholesteatoma surgery has a 5-year residual rate of 20.6% and recurrence rate of 5.1%. Long-term follow-up is recommended for reporting outcomes in pediatric cholesteatoma cases.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Epidemiology
Background:
- Cholesteatoma is a skin growth in the middle ear, commonly affecting children.
- Surgical outcomes for pediatric cholesteatoma require standardized reporting for effective comparison.
Purpose of the Study:
- To evaluate the 5-year outcomes of pediatric cholesteatoma surgery.
- To assess residual and recurrent cholesteatoma rates, otorrhea, and hearing outcomes.
Main Methods:
- A retrospective observational study of 52 primary cholesteatoma operations in 50 children (1988-2001).
- Kaplan-Meier analysis was used to determine the 5-year residual and recurrent cholesteatoma rates.
Main Results:
- The 5-year residual cholesteatoma rate was 20.6%, with a recurrence rate of 5.1%.
- At 5 years, 12.2% of ears had otorrhea, and 53% achieved socially adequate hearing (≥30 dB HL).
- 50% of ears required a second operation within 5 years, including planned staged procedures.
Conclusions:
- There is a lack of consensus in reporting pediatric cholesteatoma surgery outcomes.
- The authors recommend long-term data (≥5 years) with survival analysis for recurrence and cutoff analysis for otorrhea and hearing.
Objective:
The present report is a 5-year observational study after pediatric cholesteatoma surgery.
Study Design:
Retrospective analysis was made on pediatric cholesteatoma cases in a county hospital.
Intervention:
Between 1988 and 2001, 52 primary cholesteatoma operations were performed on 50 children.
Main Outcome Measure And Results:
Using Kaplan-Meier analysis, the residual and recurrent cholesteatoma rate at 5 years was 20.6 (95% confidence interval, 8.7-32.6%) and 5.1% (95% confidence interval, 0.0-12.1%), respectively. At the 5-year follow-up, 12.2% of the ears still have otorrhea. Socially adequate hearing (30-dB hearing level or better) was achieved in 53% of ears. Overall, 50% of the ears required a second operation within the first 5 years, including planned staged surgery for primary treatment.
Conclusion:
Currently, there is no consensus on how outcomes of cholesteatoma surgery are reported. The authors recommend that these should be long-term data (5 yr or longer), using survival analyses for recidivistic rate and cutoff analyses for postoperative otorrhea and hearing outcome.
