Our surgical treatment results in pediatric cholesteatoma

Yıl 2015, Cilt: 25 Sayı: 4, 224 - 228, 25.09.2015

Volkan Akdoğan Evren Hızal Serkan Yılmaz Haluk Yavuz Cüneyt Yılmazer Tuba Canpolat İsmail Yılmaz Levent Naci Özlüoğlu

Öz

Objectives: This study aims to evaluate surgical techniques and obtained outcomes in pediatric cholesteatoma. Patients and Methods: A total of 62 patients 41 males, 21 females; mean age 13 years; range 3 to 17 years diagnosed as pediatric cholesteatoma between January 1998 and December 2014 were enrolled into the study. Of the patients, canal wall down CWD mastoidectomy was performed in 31, canal wall up CWU mastoidectomy in 13, inside-out ISO mastoidectomy in eight, and tympanoplasty in 10. Surgical approaches, staging, hearing outcomes, relapse status, and surgical data were retrospectively analyzed. Results: Cholesteatoma recurred in seven patients 11% . Recurrence rates for CWU and CWD mastoidectomies were 31% and 6%, respectively. While the number of patients with good serviceable hearing pure-tone average ≤25 dB was 10 preoperatively, it became 16 postoperatively. Ossicular erosion was higher in CWD group. Twenty-nine patients 47% had extensive disease and CWD mastoidectomy was performed in 86% of these. Number of patients not requiring care was 45 72.6% . Conclusion: In this study, we observed no differences in terms of good serviceable hearing between CWU and CWD mastoidectomies. The preferred method was mainly CWD in patients with extensive disease and ossicular erosion. Recurrence rates were higher in CWU group. Therefore, ISO or CWD mastoidectomy come to the forefront as appropriate treatment options in the treatment of pediatric cholesteatomas according to the extensiveness of disease.

Anahtar Kelimeler

Canal wall down, canal wall up, cholesteatoma, mastoidectomy, pediatric

Pediatrik kolesteatomda cerrahi tedavi sonuçlarımız

Öz

Amaç: Bu çalışmada pediatrik kolesteatomda cerrahi teknikler ve elde edilen sonuçlar değerlendirildi.Hastalar ve Yöntemler: Ocak 1998 - Aralık 2014 tarihleri arasında kliniğimizde pediatrik kolesteatom tanısı konulan ve ameliyat edilen toplam 62 hasta 41 erkek, 21 kız; ort. yaş 13 yıl; dağılım 3-17 yıl çalışmaya alındı. Hastaların 31’ine canal wall down CWD mastoidektomi, 13’üne canal wall up CWU mastoidektomi, sekizine inside out ISO mastoidektomi ve 10’una timpanoplasti uygulandı. Cerrahi yaklaşımlar, evreleme, işitme sonuçları, nüks durumu ve cerrahi veriler geriye dönük olarak incelendi.Bulgular: Yedi hastada %11 kolesteatom nüks etti. Canal wall up ve CWD mastoidektomilerinde nüks oranı sırasıyla %31 ve %6 idi. Kullanılabilir işitmesi iyi olan saf ses ortalaması ≤25 dB hasta sayısı ameliyat öncesi 10 iken, ameliyat sonrası 16 oldu. Kemikçik erozyonu CWD grubunda daha yüksekti. Yirmi dokuz hastada %47 yaygın hastalık vardı ve bunların %86’sına CWD mastoidektomi uygulandı. Bakım gerektirmeyen hasta sayısı 45 %72.6 idi.Sonuç: Bu çalışmada iyi kullanılabilir işitme açısından CWU ve CWD mastoidektomi arasında fark gözlenmedi. Yaygın hastalık ve kemikçik erozyonu olan hastalarda tercih edilen yöntem ağırlıklı olarak CWD idi. Canal wall up grubunda nüks oranları daha yüksekti. Bu nedenle, pediatrik kolesteatomların tedavisinde hastalığın yaygınlığına göre ISO ya da CWD mastoidektomi uygun tedavi seçenekleri olarak öne çıkmaktadır

Anahtar Kelimeler

Canal wall down, canal wall up, kolesteatom, mastoidektomi, pediatrik

Kaynakça

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