Management of acquired cholesteatoma in children : A 15 year review in ENT Service of CHNU de Fann Dakar
Objectives: To analyze the epidemiology, diagnosis, management and the prognosis of cholesteatoma of
the middle ear in children.
Methods: This was a retrospective study of 15 years (from 01 January 1995 to 31 December 2009) for
patients aged 0–15 years admitted in ENT ward of FANN hospital for chronic otitis media complicated
with cholesteatoma The parameters studied were epidemiology, clinical presentation, disease
progression and management.
Results: Sixty-six participants were included. We noted a slight male predominance with a sex ratio of
1.44. The average mean age was 10 years. Most patients presented with signs of complications (69.7%)
and mastoiditis was the most common complication (63.6%). The otorrhea was noted in almost all
patients: n = 64 (97%) and deafness in 49 patients (74, 2%). There was a slight predominance of
cholesteatoma on the right side (51.5%). Schuller’s view of the mastoid cells was done in 21.2% of patients
(n = 14) and showed sclerotic mastoid air cells for all them. Eighty-two percent (82%) of patients
presented with conductive hearing loss. A radical mastoidectomy was performed in 66.7% and modified
radical mastoidectomy in 33.3% of cases. Mean follow-up was 6 months. Recurrence of cholesteatoma
was noted in 13% of cases.
Conclusions: ENT ward of Hospital Fann is one of the two centers in Senegal where cholesteatoma of the
middle ear are treated. This low number of cholesteatoma in children in a developing country is in
relation to the fact that patients only present when complications develop: 70% of cases. The reason for
this in our setting include insufficient human and manpower resources necessary for prompt
management of the disease and also lack of awareness among the populace. In these settings we
advocate canal wall down mastoidectomy (radical or modified radical) as the treatment of choice.
Auteur(s) : Diom ES, Cissé Z, Tall A, Ndiaye M, Pegbessou E, Ndiaye IC, Diallo BK, Diouf R, Diop EM.
Pages : 1998- 2003
Année de publication : 2013
Revue : International Journal of Pediatric Otorhinolaryngology 77(2013):1998-2003
N° de volume : 77
Type : Article
Statut Editorial : Revue de spécialité ORL
Mise en ligne par : TALL Abdourahmane