[Fixed retraction pockets and cholesteatoma in children. Authors' experience with 199 cases]

Cholesteatoma is more destructive in the child than in the adult, but few studies have examined the outcome as a function of age. The authors evaluated retrospectively their experience in 199 cases of cholesteatomas or uncontrollable fixed retraction pouches in children under the age of 15. Mean follow-up was 2 and a half years and the anatomic and functional results are detailed. Reasons for performing first intention or second intention canal wall up or down procedures were analyzed as a function of age. Residual cholesteatomas were particularly frequent in whatever the initial surgical procedure. Cholesteatomas and retraction pouches in the child under 5 (n = 24) were particularly aggressive and destructive, often requiring a canal wall down operation. Residual cholesteatomas were also very frequent and involved both bony and functional element of the petrus. The clinical course of cholesteatoma in the young child appears to be very different, becoming less destructive as the child reaches adulthood.