Affiliation:
1. The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia; Pirogov Russian National Research Medical University
2. The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia
Abstract
Introduction. Endoscopic ear surgery is a promising treatment for petrous bone cholesteatoma in children. Endoscopic assistance provides better visualization and the ability to manipulate in hidden areas of the formed cavity and facilitate the removal of cholesteatoma matrix from hard-to-reach areas.Aim. o systematize the accumulated knowledge about the clinical presentations of cholesteatoma of the temporal bone pyramid in children, review the modern methods of treatment and possible complications, and assess the necessity of applying endoscopic imaging devices to monitor hard-to-reach places in the temporal bone pyramid.Materials and methods. The results of surgical treatment of petrous bone cholesteatoma (PBC) in the immediate and long-term postoperative periods in children were assessed. The study included 26 children aged 8 to 18 years (average age 13.1), 21 boys and 5 girls. Dynamic follow-up after surgery was at least two years. The function of facial muscles was assessed using the House – Brackmann scale before and after surgery after 6 months, and a pure-tone audiogram was performed before and after surgery after 6 months. The approaches, options for completing the operation, complications, and relapse rates are presented.The discussion of the results. In the postoperative period, 2 people (7.7%) had normal hearing according to audiometry results, 1 (3.8%) had I degree of hearing loss, 5 (19.2%) had II degree of hearing loss, 6 (23.0%), III degree of hearing loss, in 7 (27.0%) IV degree of hearing loss, in 5 (19.2%) deafness. Function in the postoperative period was normal in 15 (57.0%) and from House – Brackmann grades II to VI in 11 (43.0%). Recurrence of cholesteatoma was detected in eight patients (30.0%) after 1–2 years.Conclusion. In children, early diagnosis of cholesteatoma of the petrous bone is important to prevent the risk of complications. The use of endoscopic assistance when removing cholesteatoma of the petrous bone provides advantages: the ability to remove the cholesteatoma matrix in hidden areas, provides a larger viewing angle and control of these areas, thereby minimizing the risks of intraoperative complications, allowing for maximum sanitization of the pathological process.