Edelstein D R, Parisier S C, Ahuja G S, Juarbe C, Chute P, Wenig S, Kaye S M
Department of Otolaryngology-Head and Neck Surgery, Manhattan Eye, Ear and Throat Hospital, New York, NY 10021.
Ann Otol Rhinol Laryngol. 1988 Jan-Feb;97(1):23-9. doi: 10.1177/000348948809700105.
The diagnosis and management of cholesteatoma in children remains controversial. In the past 15 years, the senior author (S.C.P.) has treated 320 patients with cholesteatoma. Patients 18 years and younger composed 40% (125) of the overall group and are the basis for this report. The patient data were compiled using the history, physical examination, audiograms, radiographs, patient questionnaires, surgical findings, and postoperative observations. The surgical treatment selected was determined by the extent of disease, the configuration of the mastoid, and a clinical assessment of eustachian tube function. A middle ear tympanotomy approach was used in 17% of the patients, a canal wall up procedure in 31%, and a canal wall down procedure in 52.3%. The average clinical follow-up was 3.9 years, with the range being from 3 months to 13.5 years. Hearing was maintained or slightly improved in a majority of cases. Residual disease occurred in 8% of patients, and recurrent disease in only 3%.
儿童胆脂瘤的诊断和治疗仍存在争议。在过去15年中，资深作者（S.C.P.）治疗了320例胆脂瘤患者。18岁及以下的患者占总患者数的40%（125例），也是本报告的基础。患者数据通过病史、体格检查、听力图、X光片、患者问卷、手术发现和术后观察进行收集。所选的手术治疗方法取决于疾病的范围、乳突的形态以及对咽鼓管功能的临床评估。17%的患者采用中耳鼓室切开术，31%采用外耳道后壁上翻术，52.3%采用外耳道后壁下翻术。平均临床随访时间为3.9年，范围从3个月到13.5年。大多数病例听力得以维持或略有改善。8%的患者出现残留疾病，仅3%的患者复发。
