SOVREMENNAYA PEDIATRIYA.2016.1(73):49-53; doi10.15574/SP.2016.73.49

Factors of aggressive cholesteatoma in children fnd adolescents with chronic suppurative otitis media

Kokorkin D. N. 
State institution Zaporozhye Medical Academy of Postgraduate Education, Ministry of Health, Department of Otorhinolaryngology

Objective: To identify clinically relevant factors of aggressive cholesteatoma in children and adolescents with chronic suppurative otitis media.

Materials and methods: 170 patients were operated. Cholesteatoma manifestations were compared in three age groups: children 4–12 years (n=50), adolescents 15–18 years (n=50), adult patients 20–65 years of age (n=70). We studied the influence of various factors on the emergence of aggressive cholesteatoma. The degree of influence of the factors evaluated pair and rank correlation (Spearmen). Use the software «STATISTICA- 6».

Results and discussion. The most important factor in the development of cholesteatoma — is the time factor. The younger the sick child, the more devastating effects of cholesteatoma. Children stages of the disease is inversely proportional to depend on the extent of the cholesteatoma and the number of its complications. For adolescents and adults with chronic otitis characterized by a direct correlation. In children and adolescents aggressive cholesteatoma manifested in the developed cellular structure of the mastoid process. For adult patients inhibits the spread of cholesteatoma sclerotic mastoid, preventing its wide dissemination. The associated pathology of the nose, nasopharynx and paranasal sinuses affects on the development of cholesteatoma. On the prevalence of cholesteatoma complications and the formation of nasal pathology affects differently. For children and adolescents in an inversely proportional and adult patients in the right proportion.

We have studied the background state as a factor of cholesteatoma. In our studies, autonomic dysfunction revealed only 18% of adolescents, with significant impact on the prevalence of cholesteatoma complications and the formation they are not provided. The most serious complications of cholesteatoma we found in children and adolescents with chromosomal abnormalities, median cleft face and insulin-dependent diabetes mellitus. Under these conditions, reliably predict the morphological and functional result of the operation was not possible.

Conclusion. The above factors must be considered during the determining the time of surgery in children and adolescents with chronic suppurative otitis media.

Key words: chronic otitis, cholesteatoma, children, adolescents.

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