Lee Joshua A, Fuller Stephen R, Nguyen Shaun A, Meyer Ted A
Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
Int J Pediatr Otorhinolaryngol. 2020 Aug;135:110080. doi: 10.1016/j.ijporl.2020.110080. Epub 2020 May 6.
To evaluate the effects of age, race, payer status, and socioeconomic status on complications and comorbidities in children with cholesteatoma.
An analysis of the Kids' Inpatient Database was performed on cases of cholesteatoma between 2006 and 2016, along with associated complications or co-morbidities and surgical interventions.
1552 cases of pediatric cholesteatoma represented 5.6 cases per 100,000 total discharges over the study period. The mean age was 9.9 (±5.4) years. Compared to children in the 4th age quartile, those in the 1st age quartile had decreased risk of conductive hearing loss (OR 0.64 [0.42-0.99]), venous thrombosis (OR 0.24 [0.06-0.88]), intracranial abscess (OR 0.35 [0.13-0.96]), and facial nerve palsy (0.44 [0.20-0.97]), but increased risk of chronic otitis media (OR 2.24 [1.23-4.10]). Compared to children identified as Other race, children identified as Black had increased risk of acute otitis media (OR 9.20 [1.35-62.78]). Both children identified as Black (OR 9.90 [1.48-66.35]) or Hispanic (OR 6.24 [1.01-38.51]) had increased risk of facial nerve palsy. Relative to children in the 4th income quartile, children in the 1st income quartile had increased risk of acute mastoiditis (OR 1.87 [1.15-3.03]) and subperiosteal abscess (OR 6.75 [2.22-20.56]). Children in the 2nd income quartile were less likely to receive ossicular chain surgery (OR 0.31 [0.13-0.72]).
Differences pertaining to age, race, payer status, and socioeconomic status exist in the presentation and surgical management of children hospitalized with cholesteatoma. Older children are at increased risk of intracranial complications. Patients of Black and Hispanic race might have a higher risk of facial nerve palsy. Compared to children of higher income families, those from lower income families more frequently develop acute mastoiditis and subperiosteal abscess. Providers should be mindful of these risk factors when caring for children with cholesteatoma.
评估年龄、种族、支付者状态和社会经济地位对胆脂瘤患儿并发症和合并症的影响。
对2006年至2016年间胆脂瘤病例的儿童住院数据库进行分析，同时分析相关并发症或合并症以及手术干预情况。
在研究期间，1552例小儿胆脂瘤病例占每10万次出院病例中的5.6例。平均年龄为9.9（±5.4）岁。与处于年龄四分位数第4组的儿童相比，处于年龄四分位数第1组的儿童发生传导性听力损失的风险降低（比值比[OR]0.64[0.42 - 0.99]）、静脉血栓形成风险降低（OR 0.24[0.06 - 0.88]）、颅内脓肿风险降低（OR 0.35[0.13 - 0.96]）以及面神经麻痹风险降低（0.44[0.20 - 0.97]），但慢性中耳炎风险增加（OR 2.24[1.23 - 4.10]）。与被认定为其他种族的儿童相比，被认定为黑人的儿童急性中耳炎风险增加（OR 9.20[1.35 - 62.78]）。被认定为黑人（OR 9.90[1.48 - 66.35]）或西班牙裔（OR 6.24[1.01 - 38.51]）的儿童面神经麻痹风险均增加。相对于收入四分位数第4组的儿童，收入四分位数第1组的儿童急性乳突炎风险增加（OR 1.87[1.15 - 3.03]）和骨膜下脓肿风险增加（OR 6.75[2.22 - 20.56]）。收入四分位数第2组的儿童接受听骨链手术的可能性较小（OR 0.31[0.13 - 0.72]）。
在因胆脂瘤住院的儿童的临床表现和手术治疗方面，年龄、种族、支付者状态和社会经济地位存在差异。年龄较大的儿童颅内并发症风险增加。黑人和西班牙裔种族的患者面神经麻痹风险可能更高。与高收入家庭的儿童相比，低收入家庭的儿童更频繁地发生急性乳突炎和骨膜下脓肿。在照料胆脂瘤患儿时，医疗服务提供者应留意这些风险因素。
