Cholesteatoma: Long‐term Follow‐up in Romanian Patients

Abstract

Objective: Cholesteatoma is an abnormal destructive growth of squamous epithelium in middle ear and mastoid. The presence of cholesteatoma requires surgical intervention and the main goal is to achieve a safe, dry ear and to improve hearing. The extension of surgery depends on the size of the cholesteatoma. Method: A total of 875 patients were treated for cholesteatoma in our department between 2001 and 2010, 213 pediatric patients. We performed both open and closed and technique, depending on disease extension, bone erosion, and complications, followed by second-look surgery in most of the closed-technique cases. Results: The closed technique was the treatment of choice in 69.2% cases, most of them uncomplicated cholesteatomas. In 30.6% we performed open technique for different reasons. Second look surgery was done in 57.3% of cases after 1.5 or 2 years. A total of 27.1% of patients were lost to the follow-up program after the first years. Residual cholesteatomas were noticed in 17% of the cases and the recurrent cholesteatomas were operated in 32% of the cases. After surgery the air-bone gape improved in 67.1% of the cases because of tympanoplasty with autologous graft or different types of prosthesis. In some cases we used the BAHA prosthesis. Conclusion: Cholesteatoma is a serious condition which needs surgical treatment. Second-look control in closed technique should be done after one-one and a half year. Closed technique is recommended in order to restore the function of the ear which is very important for a proper development and a good quality of life.