소아 선천성 진주종의 연령에 따른 임상적 특징과 수술 후 예후 분석

Abstract

Objective: In this study, we analyzed the clinical characteristics and surgical outcomes of chronic otitis media with congenital cholesteatoma according to age in pediatric patients.

Study Design: From August 1993 to January 2016, we retrospectively reviewed the records of 186 children (136 boys and 50 girls) less than 15 years of age with pathologically confirmed cholesteatoma. We divided the patients into three age groups and analyzed the difference of clinical variables between them. Audiologic outcome and recurrence rate were also analyzed.

Results: There were no significant difference in gender, side distribution, and reoperation rate according to age. However, there were significant differences in chief complaints, cholesteatoma type and operative methods according to age. In addition, the younger patients had fewer mastoid invasion and significantly higher incidence of intact ossicle than older patients. Ossicle erosion, mastoid invasion and open type cholesteatoma caused worse hearing outcome and high recurrence rate. Trans-canal approach showed good surgical outcome due to limited extent of disease. Preservation of posterior canal wall during mastoidectomy slightly elevated recurrence risk but did not affect hearing outcome.

Conclusion: Delayed detection of pediatric cholesteatoma can lead to extensive disease and aggressive operation which can result in worse hearing outcome and elevated recurrence risk. Physicians should familiarize themselves with the clinical characteristics of pediatric cholesteatoma, especially regarding the age distribution of this condition.