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Pediatric Cholesteatoma: An Overview of Presentation, Surgical Strategy and Outcomes of an Individualized Approach

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Pediatric cholesteatomas (PC) have multifactorial aetiology, spread aggressively and there are high chances of residual/ recurrent disease after treatment. The surgical technique to manage this entity has been debatable. This study was done to (i) enumerate the presentation of PC and the surgical techniques adopted (ii) analyse the outcomes viz., residual/ recurrence rates and hearing results. A cross sectional record based study was done on 618 cases of PC operated between 1983 and 2015, at a centre dedicated to otology and lateral skull base surgery. The data which was maintained on the basis of clinical and peri- operative findings was analysed. Otorrhea (59.2%) and hearing loss (54.2%) were the common symptoms. The surgeries done were: canal wall up (CWU) (44.3%), canal wall down (CWD) (41.1%), modified bondy’s mastoidectomy (5.7%), radical mastoidectomy (4.9%), trans canal excision (1.8%) and subtotal petrosectomy (2.3%). The residual and recurrence rates were 12.6% and 7.9% respectively. A significant difference between the pre and post operative hearing was observed. The mean improvement in air bone gap was 7.7db. Residual/ recurrent disease were higher in CWU as compared to CWD group. The surgery should be individualised so that the patient remains disease free.

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Abbreviations

CWD TPL:

Canal wall down tympanoplasty

CWU TPL:

Canal wall up tympanoplasty

STP:

Subtotal petrosectomy

TCE:

Transcanal excision

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Acknowledgements

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Funding

This research received no specific grant from any funding agency, commercial or not- for ? profit sectors.

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Authors and Affiliations

  1. Department of ENT, Akash Institute of Medical Sciences and Research Center, Bengaluru, 562110, India

    H.N Udayabhanu

  2. Department of Otology, Neurotology & Skull Base surgery, Gruppo Otologico, Piacenza-Rome, Italy

    Piras Gianluca, Vlad Diana, Taibah Abdelkader & Sanna Mario

  3. Department of ENT. Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India

    Chandra Agarwal Ashish

  4. Department of ENT, University of Parma, Parma, India

    Pasanisi Enrico

Authors
  1. H.N Udayabhanu
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  2. Piras Gianluca
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  4. Pasanisi Enrico
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  5. Vlad Diana
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  6. Taibah Abdelkader
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  7. Sanna Mario
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Contributions

Udayabhanu H.N: data collection, analysis and drafting of the manuscript. Gianluca Piras: data collection and analysis. Ashish Chandra Agarwal: drafting and revision of the manuscript. Enrico Pasanisi: data collection and analysis. Diana Vlad: data collection and analysis. Abdelkader Taibah: data collection and analysis. Mario Sanna: conceptualization, drafting and revision of the manuscript.

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Correspondence to H.N Udayabhanu.

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Udayabhanu, H., Gianluca, P., Ashish, C. et al. Pediatric Cholesteatoma: An Overview of Presentation, Surgical Strategy and Outcomes of an Individualized Approach. Indian J Otolaryngol Head Neck Surg (2024). https://doi.org/10.1007/s12070-024-04677-w

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  • DOI: https://doi.org/10.1007/s12070-024-04677-w

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