Long-term Results of Endoscopically Assisted Pediatric Cholesteatoma Surgery

ObjectiveRoutine endoscopic examination during primary surgery decreased the rate of residual cholesteatoma to 18% in our early experience. Based on this, we stopped performing routine second-look surgery in children who were endoscopically free of cholesteatoma at the end of primary surgery. We sought to investigate if second-look procedures after endoscopic-assisted surgery could safely be performed only in children at a high risk of residual disease (extensive inflammation, spontaneously ruptured or fragmented cholesteatoma, residual disease intentionally left).Study DesignCase series with chart review.SettingTertiary pediatric otolaryngology practice.Subjects and MethodsChildren aged 1 to 16 years who were treated for cholesteatoma over 15-year period by a single surgeon. Extent of disease and endoscopic findings were compared with rates of residual disease. Time to diagnosis of residual disease and prognostic factors were analyzed.ResultsForty-two children underwent endoscopically assisted middle ear...