Molinari Giulia, Reale Marella, Albera Andrea, Russo Francesca Yoshie, Di Lullo Antonella Miriam, Gaffuri Michele, Ralli Massimo, Turri-Zanoni Mario, Simon Francois, Anschuetz Lukas, Trecca Eleonora M C
Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery (GOS), Rome, Italy.
Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy.
Eur Arch Otorhinolaryngol. 2025 Jan;282(1):11-22. doi: 10.1007/s00405-024-08875-8. Epub 2024 Aug 4.
The aim of this article was to systematically review the literature on the pediatric population surgically treated for cholesteatoma and describe the applied post-operative follow-up strategies.
A systematic review was conducted following the Primary Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement recommendations. After running the selected search string in PubMed, Scopus and Google Scholar, studies in English, reporting on surgically treated pediatric cholesteatoma patients (age younger or equal to 18 year-old) were retrieved. Both primary and revision cholesteatoma surgeries were included. Articles lacking specific data on post-surgical follow-up and case series with less than 10 patients were excluded.
Nineteen papers, published between 2000 and 2023, were included for final analysis. Fourteen studies were retrospective and five prospective, for a total of 1319 patients and 1349 operated ears. Male to female ratio was 1.8:1, with a mean age at surgery of 10.4 years (range 1-18). The mean length of the follow-up after surgery was 4.4 ± 1.7 years (range 1-6.9). Clinical follow-up was detailed in 9 studies (47%) with otomicroscopy being the most common evaluation. In most articles (n = 8, 50%), MRI alone was utilized for radiological follow-up, while in 3 studies (19%), CT scans were employed exclusively. In 5 studies (31%), MRI was combined with CT scans. The timing of radiological investigations varied widely (ranging from 6 months to 3 years). A second-look strategy was reported in 14 studies (74%).
This systematic review highlights the heterogeneity of the follow-up strategies applied to pediatric patients after cholesteatoma surgery, both in terms of timing and types of investigations.
本文旨在系统回顾有关接受胆脂瘤手术治疗的儿科患者的文献，并描述所采用的术后随访策略。
按照系统评价和Meta分析的首选报告项目（PRISMA）声明的建议进行系统评价。在PubMed、Scopus和谷歌学术中运行选定的搜索词后，检索了以英文发表的、报道接受手术治疗的儿科胆脂瘤患者（年龄小于或等于18岁）的研究。原发性和复发性胆脂瘤手术均包括在内。排除缺乏术后随访具体数据的文章以及患者少于10例的病例系列。
纳入最终分析的有2000年至2023年间发表的19篇论文。14项研究为回顾性研究，5项为前瞻性研究，共有1319例患者和1349只手术耳。男女比例为1.8:1，手术时的平均年龄为10.4岁（范围1 - 18岁）。术后的平均随访时间为4.4±1.7年（范围1 - 6.9年）。9项研究（47%）详细描述了临床随访情况，其中耳显微镜检查是最常见的评估方法。在大多数文章（n = 8，50%）中，仅使用MRI进行影像学随访，而在3项研究（19%）中，仅采用CT扫描。在5项研究（31%）中，MRI与CT扫描相结合。影像学检查的时间差异很大（从6个月到3年不等）。14项研究（74%）报告了二次探查策略。
本系统评价强调了胆脂瘤手术后应用于儿科患者的随访策略在时间和检查类型方面的异质性。
