Tympano - ossicular allografts for cholesteatoma in childrenl

At the Sint Augustinus Hospital, Antwerp, Belgium, all children with cholesteatoma are operated by a canal wall up approach and immediate reconstruction with a rympano-osslcular allograft. In the majority of the cases, a second stage is performed after I year. This paper presents the results ofa retrospective review ofthe charts of 103 consecutive children treated between 7979 and 1995. The mean patient age was r0 years and the mean postoperative follow-up was 4.5 years. In 28 children residual cholesteatoma was found at the second stage operatlon and 20 developed recurrent cholesteatoma in the course of time. So far no residuál cholesteatoma surfaced after the staged procedure, but 11 children needed more than two operations to control recurrent disease. An intact, trouble-free graft was present rn 79 children at the latest follow-up. The median postoperative bone-conduction thresholds were equal to the preoperative thresholds. The median postoperative air-conduction thresholds improved in 50'% of the cases, remained unchanged in 25%,, and deteriorated in 25% of the cases' It is concluded that the tympano-ossicular allograft technique is effective and safe and offers good anatomical and acceptable functional results. @ l9t7 Elsevier Science Ireland Lrd. * corresponding author. Tel.: t 32 3 4433614; fax: t 32 3 4433611; e-mail govaerts(4)uia.ua ac be rPresented in part at the Sixth International Symposium on Recent Advances in Otitis Media, 4 g June, 1995, Fort Lauderdale. FL. -2 Present address: Department of Otorhinolaryngology, university Hospital Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands. 0165-58761971917.00 o 1997 Elsevier science Ireland Lrd A1l rights reserved. PII S0 1 6 5 5 8 7 6(97 )00 1 09 _2 32 A GM Schilder et al ilnt. J Pediatr. Otorhinolaryngol. 42 (1997) 31-40