Clinical Aspects and Surgical Outcomes of Congenital Cholesteatoma in 93 Children: Increasing Trends of Congenital Cholesteatoma from 1997 through 2012
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives: The recent increase in the reported incidence of congenital cholesteatoma (CC) may be secondary to the widespread use of otoendoscopy as well as an increased awareness of these lesions among primary care physicians. However, little research about CC has been conducted in a large group of patients. This study aimed to analyze the clinical characteristics of CC including the annual number of patients, symptoms, age at diagnosis, stage and type of disease, surgical techniques, recurrence, and postoperative complications. Subjects and Methods: Retrospective chart review was performed for patients who met the inclusion criteria between January 1997 and June 2012. Results: Ninety-three patients underwent surgery for CC. The age at operation ranged from 12 months to 17 years (mean age, 6.1 years). The number of patients was less than 4 per year until 2005, but increased to more than 10 per year since 2008. CC was most commonly reported as an incidental finding (58.1%). The operative procedures included the transcanal myringotomy approach (46.2%), canal wall up mastoidectomy (37.6%), tympanoplasty (8.6%), and canal wall down mastoidectomy (7.5%). The recurrence rate was 20.4% and the complication rate was 12.9%. No patients with stage I CC had complications. Conclusions: This study showed that the incidence of CC has recently increased notably. Most patients with stage I and II CC were completely cured by transtympanic surgery, and complication and recurrence rates increased according to the extent of disease. Early detection of CC is important to facilitate minimally invasive surgery and to reduce complication and recurrence rates.
Abstract
Background and Objectives: The recent increase in the reported incidence of congenital cholesteatoma (CC) may be secondary to the widespread use of otoendoscopy as well as an increased awareness of these lesions among primary care physicians. However, little research about CC has been conducted in a large group of patients. This study aimed to analyze the clinical characteristics of CC including the annual number of patients, symptoms, age at diagnosis, stage and type of disease, surgical techniques, recurrence, and postoperative complications. Subjects and Methods: Retrospective chart review was performed for patients who met the inclusion criteria between January 1997 and June 2012. Results: Ninety-three patients underwent surgery for CC. The age at operation ranged from 12 months to 17 years (mean age, 6.1 years). The number of patients was less than 4 per year until 2005, but increased to more than 10 per year since 2008. CC was most commonly reported as an incidental finding (58.1%). The operative procedures included the transcanal myringotomy approach (46.2%), canal wall up mastoidectomy (37.6%), tympanoplasty (8.6%), and canal wall down mastoidectomy (7.5%). The recurrence rate was 20.4% and the complication rate was 12.9%. No patients with stage I CC had complications. Conclusions: This study showed that the incidence of CC has recently increased notably. Most patients with stage I and II CC were completely cured by transtympanic surgery, and complication and recurrence rates increased according to the extent of disease. Early detection of CC is important to facilitate minimally invasive surgery and to reduce complication and recurrence rates.
참고문헌 (14)
- Levenson MJ, "Congenital cholesteatomas of the middle ear in children: origin and management", Otolaryngol Clin North Am, 22, pp.941~954 (1989)
- Friedberg J, "Congenital cholesteatoma", Laryngoscope, 104(3Pt 2), pp.1~24 (1994)
- Lee SH, "Surgical outcomes of early congenital cholesteatoma: minimally invasive transcanal approach", Laryngoscope, 124, pp.755~759 (2014)
- 김동규, "선천성 진주종의 수술 후 잔여 진주종 발생의 위험인자에 대한 고찰", 대한이비인후과학회지 두경부외과학, 51(2), pp.120~124 (2008), 대한이비인후과학회
- 유승우, "선천성 중이진주종에서 술후 재발에 관련된 위험인자", 대한이비인후과학회지 두경부외과학, 57(10), pp.664~670 (2014), 대한이비인후과학회[DOI]
- Potsic WP, "A staging system for congenital cholesteatoma", Arch Otolaryngol Head Neck Surg, 128, pp.1009~1012 (2002)
- McGill TJ, "Congenital cholesteatoma of the middle ear in children: a clinical and histopathological report", Laryngoscope, 101(6 Pt 1), pp.606~613 (1991)
- House JW, "Cholesteatoma with intact tympanic membrane:a report of 41 cases", Laryngoscope, 90, pp.70~76 (1980)
- Sanna M, "“Congenital cholesteatoma” of the middle ear. A report of 11 cases", Am J Otol, 5, pp.368~373 (1984)
- Fageeh NA, "Surgical treatment of cholesteatoma in children", J Otolaryngol, 28, pp.309~312 (1999)
- Stern SJ, "Cholesteatoma in the pediatric population:prognostic indicators for surgical decision making", Laryngoscope, 102(12 Pt 1), pp.1349~1352 (1992)
- Potsic WP, "Congenital cholesteatoma:20 years’ experience at The Children’s Hospital of Philadelphia", Otolaryngol Head Neck Surg, 126, pp.409~414 (2002)
- Stapleton AL, "Congenital cholesteatoma:predictors for residual disease and hearing outcomes", Arch Otolaryngol Head Neck Surg, 138, pp.280~285 (2012)
- Kazahaya K, "Congenital cholesteatoma", Curr Opin Otolaryngol Head Neck Surg, 12, pp.398~403 (2004)