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Updated: Oct 19, 2025
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
[Complicated cholesteatoma in a child with Down syndrome: a case report]
Roxana Spini1, Elena Arias2, Florencia Bianchi2
1División de Otorrinolaringología, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina. roxanaspini@intramed.net.
Insights
Acquired cholesteatoma in children, particularly those with Down syndrome, can lead to aggressive subperiosteal abscesses. Early surgical intervention is crucial for managing this serious complication.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Genetics
Background:
- Acquired cholesteatoma in children presents aggressive growth and high recurrence.
- Complications include intra- and extratemporal, and intracranial issues.
- Subperiosteal abscess is the most common extratemporal complication, often seen in young children.
Observation:
- Down syndrome patients exhibit predisposing factors for chronic cholesteatomatous otitis media, with over 80% prevalence.
- A case report details an 8-year-old child with Down syndrome experiencing a subperiosteal abscess.
- The abscess developed as a complication of extensive cholesteatoma.
Findings:
- The subperiosteal abscess in the reported case was a direct complication of advanced acquired cholesteatoma.
- Immediate surgical intervention was necessary for the resolution of the abscess.
Implications:
- This case highlights the significant risk of subperiosteal abscess in pediatric Down syndrome patients with cholesteatoma.
- Emphasizes the need for vigilant monitoring and prompt surgical management in this high-risk population.
- Underscores the importance of considering specific comorbidities like Down syndrome in the management of pediatric ear infections and their complications.
Abstract:
Acquired cholesteatoma in children is an aggressive disease due to its rapid growth and high recurrence rate. The complications are divided into intra-and extratemporal complications or intracranial complication. Subperiosteal abscess is the most common extratemporal complication. It is most frequent in young children. However, there are also other associated complications described in the literature. Down syndrome patients have anatomical and functional predisposing factors that contribute to chronic cholesteatomatous otitis media. The prevalence is greater than 80 %. In this report, we present a case of subperiosteal abscess in an 8-year-old child with Down’s syndrome. This abscess presented as a complication of an extended cholesteatoma and required inmediate surgery for resolution.
