PEDIATRICS Vol. 74 No. 2 August 1984, pp. 236-240
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Cholesteatoma Medial to an Intact Tympanic Membrane in 34 Young Children

Richard H. Schwartz MD1, Kenneth M. Grundfast MD1, Bruce Feldman MD1, Richard E. Linde MD1, and Karen L. Hermansen MD1

1 From the Department of Pediatrics and Department of Surgery, Section of Otolaryngology, Fairfax Hospital, Falls Church, Virginia, and Department of Otolaryngology, Children's Hospital National Medical Center, Washington, DC

Thirty-five cholesteatomas medial to intact eardrums were treated in 34 children between 1976 and 1982. Six (18%) children had never had a documented episode of otitis media. Seventeen (50%) children, in whom the lesion was diagnosed at an early stage, underwent simple excision of the cholesteatoma without the need for extensive middle ear surgery. Findings from postoperative audiograms were normal for all such children. Cholesteatoma has recurred in eight (23%) children to date. Most recurrences were diagnosed 15 months or less after surgery. Routine careful otoscopic examination is essential in order to discover cholesteatoma at an early stage and to avoid hearing loss and the need for extensive otomastoid surgery. In order to perform an accurate examination of the eardrum, a halogen-illuminated otoscope and pneumo-otoscopy should be used by the pediatrician routinely. Particular attention should be paid to the posterior-superior quadrant of the tympanic membrance where a cholesteatoma is usually located.

Key Words: cholesteatoma • intact tympanic membrance

Submitted on October 18, 1982
Accepted on April 29, 1983




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