European Archives of Oto-Rhino-Laryngology

, Volume 251, Issue 4, pp 191–195 | Cite as

A comparison of mastoid pneumatization in adults and children with cholesteatoma

  • J. Sadé
  • C. Fuchs
Original Paper


The records of 190 adults who presented over a 10-year period with previously untreated aural cholesteatomas were analyzed with respect to age, mode of presentation at the level of the tympanic membrane, and pneumatization of the mastoid. The findings were compared with those obtained in an earlier study of 109 children (aged 13 years and younger) seen over the same period of time. Two main types of cholesteatomas were found in both adults and children, most of them (82.3%) associated with sclerotic or diploic mastoids (i.e., poorly pneumatized mastoids) and the rest (17.3%) with pneumatized mastoids. The former type was found more often in adults (96.3%) than in children (57.8%), while the latter was more frequent in children (42.2% as compared to 3.7% in adults). In both adults and children, cholesteatomas associated with poorly pneumatized mastoids showed mainly an attic and mastoid distribution communicating with a pars tensa or pars flaccida retraction or marginal perforation. Cholesteatomas associated with pneumatized mastoids appeared most often behind an intact drum (the so-called congenital cholesteatomas) and were distributed mainly in the tympanic cavity.

Key words

Chronic otitis media Tympanic membrane retraction pockets Cholesteatomas Middle ear atelectasis Mastoid pneumatization 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Baron SH (1969) Management of aural cholesteatoma in children. Otolaryngol Clin North Am 2:71–88Google Scholar
  2. 2.
    Cody DTR, Taylor WF (1977) Mastoidectomy for acquired cholesteatoma. In: McCabe B, Sadé J, Abramson M (eds) Cholesteatoma. First International Conference. Aesculapius, Birmingham, Ala., p 337Google Scholar
  3. 3.
    Derlacki EL (1977) Etiological aspects in congenital cholesteatoma. In: McCabe B, Sadé J, Abramson M (eds) Cholesteatoma. First International Conference. Aesculapius, Birmingham, Ala., pp 208–211Google Scholar
  4. 4.
    Diamant M (1952) Chronic otitis. Karger, Basel, pp 11–27Google Scholar
  5. 5.
    Diamant M (1952) Chronic otitis. Karger, Basel, pp 125–139Google Scholar
  6. 6.
    Doland KD (1979) Mastoid pneumatization. In: Sade J (ed) Secretory otitis media and its sequelae. Churchill Livingstone, Edinburgh, pp 298–303Google Scholar
  7. 7.
    Griswood RE (1976) Chronic otitis media with epidermoid cholesteatoma. Clin Otolaryngol 1:337–342Google Scholar
  8. 8.
    Palva T, Karma P, Makines J (1982) The invasive theory. In: Sadé J (ed) Cholesteatoma and mastoid surgery. Kugler, Amsterdam, pp 249–264Google Scholar
  9. 9.
    Sadé J (1977) Postoperative cholesteatoma Recurrence in cholesteatoma. Aesculapius, Birmingham, Ala., pp 384–389Google Scholar
  10. 10.
    Sadé J (1982) Treatment of retraction pockets and cholesteatoma. J Laryngol Otol 46:685–704Google Scholar
  11. 11.
    Sadé J, Shatz A (1988) Cholesteatoma in children. J Laryngol Otol 102:1003–1006Google Scholar
  12. 12.
    Sadé J, Shatz A (1989) Mastoid pneumatization of otosclerosis. Ann Otol Rhinol Laryngol 98:451–454Google Scholar
  13. 13.
    Sadé J, Avraham S, Brown M (1981) Atelectasis, retraction pockets and cholesteatoma. Acta Otolaryngol (Stockh) 92:501–512Google Scholar
  14. 14.
    Sadé J, Weinberg E, Berco E, et al (1982) The marsupialised mastoid. In: Sadé J (ed) Cholesteatoma and mastoid surgery. Kugler, Amsterdam, pp 537–542Google Scholar
  15. 15.
    Sadé J, Babiazki A, Pinkus G (1983) The metaplastic and congenital origin of cholesteatoma. Acta Otolaryngol (Stockh) 96:119–129Google Scholar
  16. 16.
    Sadé J, Berco E, Fuchs C (1986) Results of preservation of the posterior canal wall in cholesteatoma surgery as related to middle ear aeration. J Laryngol Otol 100:1351–1358Google Scholar
  17. 17.
    Shatz A, Sadé J (1990) Correlations between mastoid pneumatization and the position of the lateral sinus. Ann Otol Rhinol Laryngol 99:142–145Google Scholar
  18. 18.
    Valvassori GI, Potter GD, Hanufee WN, et al (1980) Radiology of the ear, nose and throat. Thieme, Stuttgart, pp 57–59Google Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • J. Sadé
    • 1
  • C. Fuchs
    • 2
  1. 1.Ear Research Laboratory, Sackler School of Medicine and Bioengineering ProgramTel-Aviv UniversityTel-AvivIsrael
  2. 2.Department of Statistics, Raymond and Beverly Sackler Faculty of Exact ScienceTel-Aviv UniversityTel-AvivIsrael

Personalised recommendations