Surgical Outcomes In Children With Chronic Otitis Media

Abstract

We reviewed our surgical techniques and outcomes of children with chronic otitis media (COM) who had underwent surgery. The surgical outcomes and techniques of 51 ear of 49 patients were analyzed retrospectively in the totally of 89 children, aged between 8 to 16 and underwent surgery for COM. On ear examination, 16 children had perforation, 14 children had polyp, 13 children had cholesteatoma. Tympanoplasty was performed in 43% (22 ears), tympanoplasty with mastoidectomy was performed in 56% (29 ears). The canal-wall up mastoidectomy (CWUM) was performed in 25% (13 ears), and canal-wall-down mastoidectomy (CWDM) in the remaining 31% (16 ears). Graft take rate was 76.84 % and hearing gain average was 10.2 dB. In the early period , recurrent and residual diseases are more frequently in the CWUM group than in the CWDM group. In the CWDM group, the mastoid cavity problems occurred more frequently than in the CWUM group. 14 children had polyp, 12 children had cholesteatoma and one child had Langerhans cell histiocytosis (LCH) on hystopathological examination in postoperative period. Not only the hearing loss was lower in children in preoperative period, but also the hearing gain was lower in chidren in postoperative period. The surgical outcomes of tympanoplasty with or without mastoidectomy in children are successful as the results of adults. We should not avoid to perform CWDM for the risks of recurrent and residual disease in children. LCH should be kept in mind for progressive COM in children.