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Updated: Sep 1, 2025
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Is there a clinical difference in paediatric congenital cholesteatoma according to age?
C H Shin1, W S Kang1, H J Park1
1Department of Otorhinolaryngology - Head and Neck Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Insights
Delayed detection of pediatric cholesteatoma in children can lead to more extensive disease and increased surgical risks. Early diagnosis is crucial for better hearing outcomes and reduced recurrence rates after surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Imaging
Background:
- Congenital cholesteatoma is a rare condition in children.
- Surgical outcomes can vary significantly based on patient age and disease presentation.
Purpose of the Study:
- To analyze surgical outcomes in pediatric patients with congenital cholesteatoma.
- To investigate the impact of age on disease characteristics and surgical results.
Main Methods:
- Retrospective study of 186 pediatric patients (August 1993 - January 2016).
- Patients categorized into three age groups: ≤3 years, 3-7 years, and 7-15 years.
- Analysis of clinical presentation, imaging findings, surgical techniques, and recurrence rates.
Main Results:
- Significant differences observed in symptoms, cholesteatoma location, CT findings, surgical methods, ossicular erosion, and sac type across age groups.
- Older age, open-type cholesteatoma, ossicular erosion, and mastoid invasion correlated with higher recurrence rates.
- Despite pre-operative air-bone gap, hearing improvement is achievable with ossicular reconstruction in older children.
Conclusions:
- Delayed detection of pediatric cholesteatoma often results in extensive disease requiring aggressive surgery.
- Aggressive surgical approaches can negatively impact hearing outcomes and increase recurrence risk.
- Timely diagnosis and appropriate surgical management are vital for optimizing outcomes in pediatric cholesteatoma.
Objective:
This study aimed to analyse surgical outcomes of paediatric patients with congenital cholesteatoma according to age.
Method:
This was a retrospective study reviewing the records of 186 children (136 boys and 50 girls) from August 1993 to January 2016. Patients were divided into three age groups (equal to or less than 3 years, over 3 and less than 7 years, and 7 to 15 years).
Results:
There were significant differences in chief complaints, location of cholesteatoma in the middle ear, computed tomography findings, operation methods, ossicular erosion and type of cholesteatoma sac among the three groups. In addition, older age, open type cholesteatoma, ossicular erosion and mastoid invasion of cholesteatoma increased the recurrence rate after surgery. However, despite higher pre-operative air-bone gap in older children, hearing can be improved enough after proper surgery with ossicular reconstruction.
Conclusion:
Delayed detection of paediatric cholesteatoma can lead to extensive disease and the need for an aggressive operation, which can result in worse hearing outcomes and an increased recurrence risk.
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