DOI: 10.36347/sasjs.2020.v06i02.012

Pages: 74-76

Cholesteatoma is a chronic otitis media that is dangerous because of its evolving risks and potentially complications. Its clinical diagnosis is often less easy because of the difficulties of the otoscopic examination, it is more aggressive, responsible for a significant extension and a higher rate of residual cholesteatomas and recurrences. The age of the children varies between 7 and 16 years, a female predominance is found, the sex ratio is 0.5H / F, and a history otitis in 83.3%. Otorrhea and hypoacousia are the most common symptoms. A tympanic perforation is found in 88.8% of cases, a retraction pocket in 11.1% of cases, and a sentinel polyp in 11.1%. The audiometry allows to quantify the hearing loss and to follow the functional outcome of the patient; the audiogram shows pure transmission deafness in 66.66% of the cases, a mixed deafness in 22.22%. The average hearing loss is 35 dB. CT scan showed an ossicular lysis in 44.4% of the cases, wall of the stall in 50% of cases and tegmen tympani in 11.11% of cases. Canal wall up tympanoplasty, is the technique of choice in children, it was performed in all our patients. Cholesteatoma pathology is potentially dangerous in children due to their destructive and recurrent tendency. Its diagnosis must be early; CT scan remains the examination of choice for the preoperative extension of the diagnosis. New delayed gadolinium-enhanced T1-weighted and diffusion-weighted MRI sequences have recently been developed and provide more precise radiological diagnosis for postoperative follow-up. Treatment of cholesteatoma is exclusively surgical and the Canal wall up tympanoplasty remains preferred in children. Recurrence is a real problem of surgery; and therefore, it is necessary to closely monitor any patient operated for cholesteatoma since no cure can be affirmed for five years.