소아 진주종성 중이염의 수술소견에 대한 분석

Cholesteatoma in children is more aggressive and rapid growth into the adjacent structure than in adult. It is classified into congenital or acquired. Most cholesteatomas in children are developed attic or marginal retraction pocket due to Eustachian tube dysfunction. Also, congenital cholesteatoma occurs behind an intact tympanic membrane.

Authors have investigated retrospectively 29 cases of cholesteatoma in children under 16- year-old age, operated in our department for about 10 years. We have analysed the findings of temporal bone CT and operation. Acquired cholesteatomas including recurrent or residual type were 93.1 % and congenital cholesteatomas were 6.9%. The development of mastoid was pneumatic type in 48.3%, sclerotic in 37.9 % and diploic in 13.8%. In 55.2% of cases, cholesteatoma widely extended into middle ear, attic and mastoid antrum. Auditory ossicles were most vulnerable structure. Erosion of the incus was occurred 62.1 %, followed by involvement of the stapes 44.8% and the malleus 27.6 %. Facial nerve’s bony canal and the bony labyrinth including the semicircular canals and the cochlea were infrequently eroded. But subperiosteal abscess was 13.8 % due to erosion of mastoid cortex. Intracranial complications resulting from erosion of tegmen were meningitis 6.9%, and brain abscess 3.4%.