Publication:

Paediatric acquired cholesteatoma, our experience in a tertiary care: two year prospective study

Background Aim of the study was to estimate the benefits of having high-resolution computed tomography (HRCT) of temporal bone on clinically evaluated paediatric patients of acquired cholesteatoma.

Methods A total of 60 patients of paediatric age group (2-18 years) who were diagnosed with active squamosal type of chronic otitis media were selected for the study. HRCT of temporal bone was done in all the patients and findings were recorded.

Results Most patients were in the age group of 11-15 years (46.6%). Findings of pars tensa were subtotal perforation in 2 patients (3.3%), small central perforation in 8 patients (13.3%) and postero-superior marginal perforation in 12 patients (20%). Pars flaccida retraction pocket with cholesteatoma was seen in 31 patients (51.6%) and perforation with cholesteatoma in 13 patients (21.6%). Scutum erosion was seen in 31 patients (51.6%), ossicular erosion in 12 patients (20%) and facial nerve paralysis in 2 patients (3.3%). On HRCT temporal bone we found soft tissue density in middle ear in 60 patients (100%), soft tissue density in mastoid in 53patients (88.3%), osscicular erosion in 54 patients (90%), scutum erosion in 46 patients (76.6%), facial nerve canal dehiscence in 5 patients (8.3%), semicircular canal dehiscence in 2 patients (3.3%) and dural plate dehiscence in 11 patients (18.3%).

Conclusions HRCT of temporal bone is helpful in depicting a clearer picture of middle ear cavity structures involved by cholesteatoma and thus helpful in formulating a strategy for further management.