Palva A, Karma P, Kärjä J
Arch Otolaryngol. 1977 Feb;103(2):74-7. doi: 10.1001/archotol.1977.00780190054003.
The 65 cholesteatomas operated on in children showed a more expansive and rapid growth than those in adults. In one fifth of the cases cholesteatoma filled the whole air-cell area, which was wide in half of the children. Fifty-two ears of these children had an attic or a posterosuperior perforation. One case was complicated by a fistula in the horizontal semicircular canal, and the ossicular chain was unbroken in 23 cases (35%). Thus, the findings support the idea of the primary soft-tissue spread of cholesteatoma in children. Five ears (8%) discharged postoperatively, and three ears (5%) were reoperated on and showed residual tympanal cholesteatoma. Cavity obliteration with canal wall down technique proved safe, even in the cases of the most extensive and active cholesteatoma.
65例接受手术的儿童胆脂瘤比成人胆脂瘤生长更具侵袭性且更快。五分之一的病例中，胆脂瘤占据了整个气房区域，半数儿童的气房区域较宽。这些儿童中有52耳存在上鼓室或后上穿孔。1例并发水平半规管瘘，23例（35%）听骨链完整。因此，这些发现支持儿童胆脂瘤原发性软组织扩散的观点。5耳（8%）术后有分泌物，3耳（5%）再次手术，显示有残余鼓室胆脂瘤。即使在胆脂瘤最广泛且活跃的病例中，采用开放式乳突根治术进行鼓室成形术也证明是安全的。
