Management of childhood cholesteatoma

We report a retrospective study of 54 children with 57 involved ears who underwent surgery for cholesteatoma before their sixteenth birthdays. The majority of these underwent open cavity operations (modified radical mastoidectomy, radical mastoidectomy or atticotomy). The incidence of residual disease was only 6 per cent and overall 70 per cent of ears have been free of chronic discharge. The post-operative hearing thresholds were disappointingly low, though overall no worse than those recorded before surgery. The mean post-operative hearing level for the group was 39 dB and the mean air-bone gap was 29 dB. Open cavity surgery is the method of choice for childhood cholesteatoma, mainly because of the low incidence of residual disease.