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Prevalence of Cholesteatoma in School Children of Nepal
Milan Maharjan1, Samira Rajbhandari1, Shristi Subba1
1Department of Ear, Nose, and Throat, Ear Care Nepal, Star Hospital, Sanepa Height, Lalitpur, Nepal.
Insights
Cholesteatoma is more prevalent in Nepalese children, affecting 0.20% of those screened. Early detection through school programs is crucial to prevent serious complications like hearing loss.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Public Health
Background:
- Cholesteatoma is a challenging otolaryngologic condition, particularly aggressive in children.
- Untreated cholesteatoma can lead to severe complications including hearing loss, facial paralysis, and intracranial infections.
Purpose of the Study:
- To determine the prevalence of cholesteatoma in school-aged children in Nepal.
- To assess the impact of early diagnosis and management on reducing cholesteatoma-related morbidity.
Main Methods:
- Retrospective analysis of medical records from school-based ear screening programs (2014-2024).
- Inclusion criteria: confirmed diagnosis of chronic otitis media with cholesteatoma after microscopic re-examination.
- Data collected: personal details, medical history, ear findings, and audiometry results.
Main Results:
- Prevalence of chronic otitis media with cholesteatoma was 0.20% (282/143,544 children).
- Overall prevalence of chronic otitis media was 7.56% (10,853/143,544 children).
- Hearing loss was present in 96.81% (273/282) of cholesteatoma cases, predominantly conductive hearing loss.
Conclusions:
- Nepalese children exhibit a higher prevalence of cholesteatoma.
- Regular school screening programs are vital for early detection and management.
- Prompt diagnosis and treatment significantly reduce the risk of severe complications and long-term morbidity.
Introduction:
Cholesteatoma remains a serious condition that poses a challenge to otolaryngologists around the world. It is found to be more aggressive in the pediatric group than in adults. If left untreated, the disease can be dangerous due to its ability to expand and destroy bones, leading to complications such as hearing loss, vestibular dysfunction, facial paralysis, and intracranial infections.
Objective:
To find out the prevalence of cholesteatoma in the school-aged children of Nepal.
Methods:
This is a retrospective study conducted within a span of 10 years from 2014 to 2024 in which all medical records of the school-based ear screening programs were studied. Data including personal details, brief history, and ear and audiometry findings were recorded. All suspected cases of cholesteatoma were reexamined under microscope at our institute, and only those with confirmed diagnosis of chronic otitis media (COM) with cholesteatoma were included in the study.
Results:
Out of the total of 143,544 children screened, COM with cholesteatoma was diagnosed in 0.20% (n = 282), and COM in total in 7.56% (n = 10,853). Hearing loss was seen in 273 (96.81%) of the 282 cases, with conductive hearing loss being the most common type of hearing loss.
Conclusion:
There is a higher prevalence of cholesteatoma in Nepalese children. Early diagnosis with proper management helps reduce the chances of life-threatening complications. Thus, having regular screening programs in school children will help in reducing morbidity.
