Radiological differences between HIV-positive and HIV-negative children with cholesteatoma

Area of Science:

• Otolaryngology
• Pediatric Radiology
• Infectious Diseases

Background:

• Children with Human Immunodeficiency Virus (HIV) may have an increased susceptibility to developing cholesteatoma.
• Chronic middle ear inflammation, potentially more prevalent in HIV-positive children, could predispose them to cholesteatoma.
• Limited research exists on the radiological characteristics of the middle ear cleft in HIV-positive versus HIV-negative children with cholesteatoma.

Purpose of the Study:

• To radiologically compare the middle ear cleft in HIV-positive and HIV-negative pediatric patients diagnosed with cholesteatoma.
• To identify potential differences in mastoid air cell systems (MACS) and mastoid bone density between the two groups.

Main Methods:

• A retrospective, cross-sectional, observational study was conducted.
• Evaluated 51 ears from 40 patients with cholesteatoma over a six-year period.
• Compared radiological findings between HIV-positive and HIV-negative children.

Main Results:

• HIV-positive patients exhibited significantly smaller mastoid air cell systems (MACS) (p=0.02).
• Forty percent of HIV-positive patients had sclerotic mastoids, compared to only 3% of HIV-negative patients (p<0.02).
• Eighty-two percent of HIV-positive patients had bilateral cholesteatoma, versus 7% in the control group (p<0.02).

Conclusions:

• HIV-positive children with cholesteatoma are more likely to present with smaller, sclerotic mastoids and bilateral disease.
• These findings suggest HIV infection is a risk factor for cholesteatoma development in children.
• Implications for surveillance, management, and follow-up strategies for HIV-positive children are indicated.