[Cholesteatoma in children. Apropos of 104 cases]

Between 1988 and 1993, 94 children from 3 to 15 years of age underwent one or more surgical procedures for cholesteatoma or epithelization of the middle ear space. Ten children had bilateral disease. 94 ears were operated for the first time and 10 ears had had previous surgery at other institutions. A total of 204 procedures were performed: 190 for cholesteatoma and 14 for epithelization of the middle ear space. Preoperative audiometry showed a mean air-bone gap of 30 decibels. 69% of the ears had ossicular osteolysis. The surgical technique was decided at the time of surgery. This was most often a canal-wall-up procedure which was almost routinely followed by surgical revision (92%). Pearl-like masses or recurrent cholesteatoma were frequently found at the second or third operation (73%) but most could ultimately be controlled with a canal-wall-up procedure. A canal-wall-up down procedure was necessary in 20% of the ears at either the second or third operation because of important residual or recurrent cholesteatoma. Post-operative audiometry showed a mean air-bone gap of 30 decibels.