Article
Surgical management of middle ear cholesteatoma: clinical and functional outcomes
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Published: | April 19, 2011 |
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Introduction: Cholesteatoma is an abnormal growth of squamous epithelium in the middle ear and mastoid which destroy important structures in the temporal bone. The presence of cholesteatoma requires surgical intervention and the main goal is to achieve a safe, dry ear and to improve the hearing. The extension of surgery depends on the size of the cholesteatoma.
Methods: 875 patients were treated for cholesteatoma in our department between 2001 and 2010, 213 pediatric patients. We performed both open and closed and technique, depending on disease extension, bone erosion and complications, followed by second-look surgery in most of the closed-technique cases.
Results: The closed technique was the treatment of choice in 69,2% of cases, most of them uncomplicated cholesteatomas. In 30,6% we've chose the open technique for different reasons. The second look surgery was done in 57,3% of cases after one and a half or two years. 27,1% of patients were lose of follow-up program after the first years. Residual cholesteatomas were noticed in 17% of cases and the recurrent cholesteatomas were operated in 32% of cases. After the surgery the air-bone gape has improved in 67,1% of cases because of tympanoplasty with autologous graft or different types of prosthesis. In some cases we've used the BAHA prosthesis with good results.
Conclusions: Cholesteatoma is a serious condition which affect both children and adults. The second-look control in closed technique should be done after one-one and a half year. Closed technique is recommended in order to restore the function of the ear, the hearing, which is very important for a normal development and a proper quality of life.