Updates in Pediatric Cholesteatoma: Minimizing Intervention While Maximizing Outcomes

Otolaryngol Clin North Am. 2019 Oct;52(5):813-823. doi: 10.1016/j.otc.2019.05.003. Epub 2019 Jul 5.

Abstract

Advances in pediatric otology have provided new tools to diagnose and manage complex otologic disease. Diffusion-weighted MRI provides the surgeon with a tool to detect recurrent or residual cholesteatoma that may obviate a second look surgery. Surgical trends move toward less invasive surgery. The literature provides good evidence to advocate for preserving the posterior ear canal and single stage ossiculoplasty. The growing popularity and increasing evidence in the literature supports otoendoscopy as a means to minimize invasiveness while eradicating disease in previously difficult to reach anatomic locations. These advances have allowed the otologic surgeon to improve surgical outcomes while minimizing intervention.

Keywords: Cholesteatoma; Diffusion weighted MRI; Endoscopy; Eustachian tube dysfunction; Mastoidectomy; Ossiculoplasty; Otitis media with effusion.

Publication types

  • Review

MeSH terms

  • Child
  • Cholesteatoma, Middle Ear / diagnostic imaging*
  • Cholesteatoma, Middle Ear / surgery*
  • Diffusion Magnetic Resonance Imaging
  • Endoscopy / methods*
  • Humans
  • Mastoidectomy
  • Minimally Invasive Surgical Procedures / methods*
  • Otitis Media with Effusion / diagnostic imaging
  • Otitis Media with Effusion / surgery
  • Otologic Surgical Procedures / methods*
  • Recurrence
  • Second-Look Surgery / statistics & numerical data*
  • Treatment Outcome