Cholesteatoma in children.

Cholesteatoma in children is a particularly difficult disorder because of the special developmental issues unique to the age group and the long-term follow-up implications of surgical changes to the ear. The two basic controversies are canal-wall-up versus canal-wall-down surgery, and staged versus single-stage surgery. No single philosophy is applicable to all children with cholesteatoma. Instead, the surgeon should individualize the management of pediatric cholesteatoma by considering the location and extent of the cholesteatoma, the overall status of infections and hearing, socioeconomic issues of access to follow-up and future surgery, and the likelihood of compliance with the full management plan.