Surgery for Middle Ear Cholesteatoma in Children

Various surgical procedures have been used to eradicate cholesteatoma. The advantages and disadvantages of the open and closed methods are discussed. Having used both methods to treat cholesteatoma in children, we present the results obtained from each of these methods. Thirty-three patients with middle ear cholesteatoma were treated surgically between January 1982 and December 1990 at the Department of Otolaryngology, Okayama University. All subjects were under the age of 15. All children were treated by either the closed method or the open method. Residual disease was found in 52.2% of the cases treated by the closed method and 30.0% of those treated by the open method, the overall rate of residual disease was 45.5%. The rates of recurrence were 26.1% and 0%, respectively, with a combined rate of 18.2% for all patients. Overall, 60.9% of the patients treated by the closed method and 30.0% of those treated by the open method had residual and/or recurrent cholesteatoma. The combined rate of residual and recurrent disease for all patients was 51.5%. The hearing results obtained by the two methods were nearly the same. In the open method, the incidence of postoperative problems was insignificant and there were fewer surgical procedures per ear. From our results, we conclude that the open method is more useful in treating cholesteatoma in children.