[Long-term results of cholesteatoma surgery in children].

In the long-term results, a large percentage of failures of pediatric cholesteatoma surgery (recurrent and residual), as well with the open and closed (ICWT) techniques and motive for the low rates of functional results are a reflection for most authors about the best surgical technique for improving anatomical-functional results. A total of 57 cases of children's cholesteatoma (3-11 years) operated on in a five-year period (1983-1990) with follow-up surgery to 7 years was analyzed statistically. The location of the cholesteatoma in most cases was in the attic and mastoid (72%) with extension to middle ear in 77% and ossicular chain destruction in 80% of cases. In 54% of cases, radical mastoidoepitympanectomy was performed, in 40% mastoidectomy or attico-antrotomy with tympanoplasty and reconstruction of posterior wall with homologous and alloplastic materials, and only in 5.2%, intact canal wall tympanoplasty. Pathological failure (residual + recurrent cholesteatoma) occurred in 17.5% (12.9% with the radical mastoidepitympanectomy, 21% with the reconstructive techniques and 33% with ICWT). The hearing results were better in 17.5% of cases (average 20.2 dB) and hearing loss occurred in 10.5%. At the present time, in most cases the surgical technique used is radical mastoidoepitympanectomy (12.9% of failures).