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Updated: Apr 6, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
[Our surgical treatment results in pediatric cholesteatoma]
M Volkan Akdoğan1, Evren Hızal, Serkan Yılmaz
1Department of Otolaryngology, Medical Faculty of Başkent University, 06490 Bahçelievler, Ankara, Turkey. drmvolkan@hotmail.com.
Insights
This study evaluated surgical techniques for pediatric cholesteatoma. Canal wall down (CWD) mastoidectomy is preferred for extensive disease, showing lower recurrence rates than canal wall up (CWU).
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Outcomes
Background:
- Pediatric cholesteatoma presents unique surgical challenges.
- Evaluating surgical techniques is crucial for optimizing outcomes in children.
Purpose of the Study:
- To assess surgical techniques and outcomes in pediatric cholesteatoma.
- Compare hearing results, recurrence rates, and disease management strategies.
Main Methods:
- Retrospective analysis of 62 pediatric cholesteatoma patients (1998-2014).
- Surgical approaches included canal wall down (CWD), canal wall up (CWU), inside-out (ISO) mastoidectomy, and tympanoplasty.
- Evaluation of surgical approach, staging, hearing, and recurrence.
Main Results:
- Overall recurrence rate was 11% (CWU: 31%, CWD: 6%).
- Good serviceable hearing improved postoperatively (10 to 16 patients).
- Canal wall down (CWD) mastoidectomy was preferred for extensive disease (86% of cases).
Conclusions:
- No significant difference in serviceable hearing between CWU and CWD mastoidectomies.
- CWD mastoidectomy is favored for extensive disease and ossicular erosion.
- ISO or CWD mastoidectomy are recommended for pediatric cholesteatoma based on disease extent.
Objectives:
This study aims to evaluate surgical techniques and obtained outcomes in pediatric cholesteatoma.
Patients And Methods:
A total of 62 patients (41 males, 21 females; mean age 13 years; range 3 to 17 years) diagnosed as pediatric cholesteatoma between January 1998 and December 2014 were enrolled into the study. Of the patients, canal wall down (CWD) mastoidectomy was performed in 31, canal wall up (CWU) mastoidectomy in 13, inside-out (ISO) mastoidectomy in eight, and tympanoplasty in 10. Surgical approaches, staging, hearing outcomes, relapse status, and surgical data were retrospectively analyzed.
Results:
Cholesteatoma recurred in seven patients (11%). Recurrence rates for CWU and CWD mastoidectomies were 31% and 6%, respectively. While the number of patients with good serviceable hearing (pure-tone average ≥25 dB) was 10 preoperatively, it became 16 postoperatively. Ossicular erosion was higher in CWD group. Twenty-nine patients (47%) had extensive disease and CWD mastoidectomy was performed in 86% of these. Number of patients not requiring care was 45 (72.6%).
Conclusion:
In this study, we observed no differences in terms of good serviceable hearing between CWU and CWD mastoidectomies. The preferred method was mainly CWD in patients with extensive disease and ossicular erosion. Recurrence rates were higher in CWU group. Therefore, ISO or CWD mastoidectomy come to the forefront as appropriate treatment options in the treatment of pediatric cholesteatomas according to the extensiveness of disease.
