The relationships among mastoid air cell development, tympanic sinus depth, and residual disease after surgery in children with congenital cholesteatoma

Abstract

Background: Mastoid development, tympanic sinus depth, and residual disease after surgery for congenital cholesteatoma are probably related, but these relationships have not been examined in detail.

Aims/objectives: This study aimed to clarify the relationships between the abovementioned factors. Materials and Methods: The subjects were 31 patients with congenital cholesteatoma (stage III or IV in Potsic’s staging system) that underwent mastoidectomy. The cross-sectional area of the mastoid air cells was measured as described previously. Tympanic sinus depth was classified into A–C using Marchioni et al.’s system.

Results: Patients with deep tympanic sinuses or residual disease exhibited significantly greater mastoid air cell development. However, little residual disease was found in the mastoid air cells. Conversely, residual disease was observed more frequently in the patients with deep tympanic sinuses.

Conclusions and significance: After surgery for congenital cholesteatoma, residual disease is more likely to occur in patients with marked mastoid growth, possibly because they have deep tympanic sinuses. Cases in which congenital cholesteatoma spreads to the mastoid air cells are classified as stage IV in Potsic’s system, but our findings indicate that invasion into a deep tympanic sinus is more important than invasion into the mastoid air cells.

Chinese abstract

背景：乳突发育、鼓室窦深度和先天性胆脂瘤术后残留疾病可能是相关的, 但这些关系尚未被详细研究。

目的：本研究旨在澄清上述因素之间的关系。

材料与方法：研究对象是接受乳突切除术的31例先天性胆脂瘤患者（Potsic分期系统的III、IV期）。对乳突气细胞的横截面积进行测量。使用Marchioni等人的系统将鼓室窦深度分为A、B、C三类。

结果：鼓室窦深的或残留病变患者的乳突气细胞显示较强度的发育。然而, 乳突气细胞中几乎没有残留疾病。相反, 在鼓室窦深的患者中, 残留病变更为常见。

结论及意义：先天性胆脂瘤术后乳突生长明显者, 更易发生残留病, 可能是因为其鼓室窦深。在Potsic系统中, 先天性胆脂瘤扩散到乳突气细胞的病例被归类为IV期, 但我们的发现表明, 扩散到鼓室窦深处比扩散到乳突气细胞更为重要。

Keywords:

• Congenital cholesteatoma
• mastoid pneumatization
• tympanoplasty
• residual disease
• tympanic sinus

Disclosure statement

The authors have no conflicts of interest directly relevant to the content of this article.