The status of the contralateral ear in children with acquired cholesteatoma

Abstract

Conclusion: The high prevalence of pathological changes in the contralateral ear (CLE) among children treated because of middle ear cholesteatoma (MEC) was observed. Evolution of many retraction pockets into cholesteatoma points to the need for early intervention in those patients, especially those with concomitant attic retraction pockets and secretory otitis media (SOM). Objectives: The aim of the study was to assess the frequency of pathological changes in the CLE of children operated because of MEC, and to determine their clinical evolution. Methods: Retrospective analysis was performed on the basis of medical records of 202 patients treated surgically for MEC in the years 1998–2011. The mean age of included patients was 11 years and the mean observation period was 54 months. Otoscopic findings before surgery were compared with the latest examination. Results: At the time of surgery for MEC, 54.5% of CLEs presented with abnormalities. The most frequent findings were retraction of the tympanic membrane (30%) and SOM, 22.4%. Also, 7% of patients presented with bilateral MEC. Thirty-four percent (20 cases) of retraction pockets diagnosed at the beginning of the observation period required surgical intervention. During the intervention in 20% of cases (12/59 cases) diagnosis of cholesteatoma was confirmed. At the end of the observation period bilateral cholesteatoma was diagnosed in 12.9% of children.

Keywords::

• Retraction pocket
• sequelae of otitis media with effusion
• chronic otitis media

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the writing and content of the paper.