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[The status of contralateral ear in children with cholesteatoma]
Agnieszka Kurzyna1, Krzysztof Trzpis, Elzbieta Hassmann-Poznańska
1Klinika Otolaryngologii Dzieciecej, Uniwersytetu Medycznego w Białymstoku. pedorl@umwb.edu.pl
Insights
Over 46% of children with middle ear cholesteatoma (MEC) show contralateral ear changes, most commonly retraction pockets. Systematic examination of the contralateral ear is crucial for early detection and management in pediatric MEC patients.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Medical Research
Context:
- Middle ear cholesteatoma (MEC) affects a significant number of patients, with recent data suggesting over 60% exhibit contralateral ear (CE) changes.
- Existing research on CE conditions, particularly in pediatric populations, is limited.
Purpose:
- To evaluate the prevalence of pathological changes in the contralateral ear of children undergoing surgery for MEC.
- To analyze the clinical progression and evolution of these contralateral ear abnormalities.
Summary:
- A retrospective analysis of 193 pediatric patients with MEC revealed abnormalities in 46.1% of contralateral ears.
- Retraction pockets were the most frequent finding (23%), with cholesteatoma identified in 8 cases.
- No correlation was found between CE abnormalities and patient age or MEC type; bilateral cholesteatoma occurred in 9.3% of cases.
Impact:
- Highlights the high incidence of contralateral ear pathology in pediatric MEC.
- Underscores the necessity for routine contralateral ear examination in children diagnosed with MEC.
- Informs clinical practice regarding the monitoring and treatment of contralateral ear conditions in pediatric patients.
Introduction:
Recently published data indicate that over 60% of patients with middle ear cholesteatoma (MEC) have concomitant changes in the contralateral ear (CE). Studies concerning the condition of the CE are few and rarely present the situation in the pediatric population.
The Aim Of This Study:
was to assess the frequency of pathological changes occurring in the CE in children operated on MEC, as well as to determine their clinical evolution.
Material And Method:
Retrospective analysis was performed on basis of medical records of 193 patients treated surgically for MEC in 1998-2008 at the Department of Pediatric Otolaryngology in Bialystok. The comparison of otoscopic evaluation before first operation with the latest examination was undertaken. The evolution of abnormalities was analyzed and the effect of age and type of cholesteatoma was assessed.
Results:
The opposite ears were abnormal in 46.1% of patients. Most frequently observed changes in the CE were retraction pockets (23%). Cholesteatoma was found in 8 of 45 identified cases of retraction pocket. The incidence of abnormalities in the CE was not correlated with patients age or type of cholesteatoma. Cholesteatoma occurred on both sides in 9,3% of children. In these cases, the attic cholesteatoma was presented in 66.67%, tensa cholesteatoma in 16.67%.
Conclusions:
In patients with MEC contralateral ear should be systematically examined to detect early any abnormality, or to assess their evolution and take appropriate treatment.
