Treatment of cholesteatoma in children. A long-term study of results

The late results of cholesteatoma surgery in a consecutive study of 122 children primarily operated on in one stage from 1965 to 1978 and seen at follow-up several times are presented. Of the children, 97 percent were seen at least once during an observation period of 2 to 16 years. Recurrent cholesteatoma was found in 12 percent, of whom 8 percent had residual cholesteatoma in the tympanic cavity, 2 percent in the attic, and 2 percent had recurrent cholesteatoma in the attic. Results with a modified canal up technique were slightly better than with canal down technique. Retractions in the attic using canal up technique were found in 30 percent, but the openings gradually increased and they ended up being harmless, self-cleaning cavities. The results of various hearing tests were satisfactory--best in cases with an intact ossicular chain, which it is recommended always to preserve. Cholesteatoma surgery must be strictly individualized according to the pathology of the patient. No single method is superior in all cases.