• Clinico-morphological features of aggressive cholesteatoma in children and adollescents with chronic suppurative otitis media 
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Clinico-morphological features of aggressive cholesteatoma in children and adollescents with chronic suppurative otitis media 

SOVREMENNAYA PEDIATRIYA.2015.4(68):37-40; doi 10.15574/SP.2015.68.37 
 

Clinico-morphological features of aggressive cholesteatoma in children and adollescents with chronic suppurative otitis media 
 

Kokorkin D. N.

State institution Zaporozhye Medical Academy of Postgraduate Education, Ministry of Health, Department of Otorhinolaryngology 
 

Actuality. Until today among otolaryngologists no established definition what means «aggressive cholesteatoma». Most authors link the notion from childhood, believing that any cholesteatoma in children behaving aggressively. Cholesteatoma activity limited choice of options of surgery and leads to a large number of relapses. 
 

Objective: To identify the most important clinical and morphological features of aggressive cholesteatoma in children and adolescents with chronic suppurative otitis media. 
 

Materials and methods: operated and observed 170 patients. Cholesteatoma compared manifestations in three age groups: children 4–12 years (n=50), adolescents 15–18 years (n=50), adult patients 20–65 years (n=70). The diagnosis of chronic otitis media with cholesteatoma confirmed by the results of otomicroscopy, acumetry and CT-examination of the temporal bone. 
 

Results and discussion of aggressive cholesteatoma occurs most often in children (64%). In 80% of children cholesteatoma filled all the departments of the middle ear, bones destruction circuit was detected in 82% of patients. In 30% of cholesteatoma cases meninges were bared, and 2% of patients formed intracranial complications. Cholesteatoma in adollscents formed in 5–6 years, in 52% cases cholesteatoma fulfilled the middle ear cavity, and destroyed the ossicular chain in 76% of patients, exposed the meninges in 17% of cases. In adult patients cholesteatoma has been formed for two decades. The destruction of the ossicular chain was detected in 72% of patients, exposured of the meninges 20% of patients. 
 

Conclusion aggressive cholesteatoma in children develops rapidly and asymptomatic. From the first symptoms before the operation took place not more than 6 months. The disease occurs in the absence of hearing loss and minimal complaints of the child. Within a short period of aggressive children cholesteatoma reaches the same complications as cholesteatoma in adults. This factor must be considered during planning surgery in children with cholesteatoma. 
 

Key words: chronic otitis, cholesteatoma, children, adolescents 
 

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