Related Experiment Video
Updated: Dec 21, 2025
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Factors affecting complications and comorbidities in children with cholesteatoma
Joshua A Lee1, Stephen R Fuller1, Shaun A Nguyen1
1Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
Insights
Pediatric cholesteatoma presentation and surgical management vary by age, race, and socioeconomic status. Younger children face fewer intracranial complications, while lower-income children have higher risks of mastoiditis and abscesses.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Health Services Research
Background:
- Cholesteatoma in children is a complex condition requiring surgical intervention.
- Understanding demographic disparities in pediatric cholesteatoma is crucial for equitable care.
Purpose of the Study:
- To investigate the impact of age, race, payer status, and socioeconomic status on complications and comorbidities in pediatric cholesteatoma.
- To identify risk factors influencing the presentation and surgical management of pediatric cholesteatoma.
Main Methods:
- Analysis of the Kids' Inpatient Database (2006-2016) for pediatric cholesteatoma cases.
- Inclusion of data on associated complications, comorbidities, and surgical interventions.
- Statistical analysis to compare outcomes across different demographic groups.
Main Results:
- Younger children (1st quartile) showed reduced risks for conductive hearing loss, venous thrombosis, intracranial abscess, and facial nerve palsy, but increased risk for chronic otitis media.
- Black children had a higher risk of acute otitis media, and Black and Hispanic children faced increased risk of facial nerve palsy.
- Children from lower socioeconomic status (1st income quartile) had elevated risks of acute mastoiditis and subperiosteal abscess, while those in the 2nd income quartile were less likely to undergo ossicular chain surgery.
Conclusions:
- Significant disparities in pediatric cholesteatoma presentation and management exist based on age, race, payer status, and socioeconomic status.
- Older children are more prone to intracranial complications.
- Racial and socioeconomic factors are associated with specific complications like facial nerve palsy, acute mastoiditis, and subperiosteal abscess, necessitating provider awareness.
Objective:
To evaluate the effects of age, race, payer status, and socioeconomic status on complications and comorbidities in children with cholesteatoma.
Methods:
An analysis of the Kids' Inpatient Database was performed on cases of cholesteatoma between 2006 and 2016, along with associated complications or co-morbidities and surgical interventions.
Results:
1552 cases of pediatric cholesteatoma represented 5.6 cases per 100,000 total discharges over the study period. The mean age was 9.9 (±5.4) years. Compared to children in the 4th age quartile, those in the 1st age quartile had decreased risk of conductive hearing loss (OR 0.64 [0.42-0.99]), venous thrombosis (OR 0.24 [0.06-0.88]), intracranial abscess (OR 0.35 [0.13-0.96]), and facial nerve palsy (0.44 [0.20-0.97]), but increased risk of chronic otitis media (OR 2.24 [1.23-4.10]). Compared to children identified as Other race, children identified as Black had increased risk of acute otitis media (OR 9.20 [1.35-62.78]). Both children identified as Black (OR 9.90 [1.48-66.35]) or Hispanic (OR 6.24 [1.01-38.51]) had increased risk of facial nerve palsy. Relative to children in the 4th income quartile, children in the 1st income quartile had increased risk of acute mastoiditis (OR 1.87 [1.15-3.03]) and subperiosteal abscess (OR 6.75 [2.22-20.56]). Children in the 2nd income quartile were less likely to receive ossicular chain surgery (OR 0.31 [0.13-0.72]).
Conclusion:
Differences pertaining to age, race, payer status, and socioeconomic status exist in the presentation and surgical management of children hospitalized with cholesteatoma. Older children are at increased risk of intracranial complications. Patients of Black and Hispanic race might have a higher risk of facial nerve palsy. Compared to children of higher income families, those from lower income families more frequently develop acute mastoiditis and subperiosteal abscess. Providers should be mindful of these risk factors when caring for children with cholesteatoma.
More Related Videos
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:30Pneumonia III: Complications and Assessment
01:18Factors Affecting Illness
For instance, risk factors are connected to illness,...