THE CAUSE OF AURAL POLYPS IN CHILDREN

This 20-year retrospective review identifies 35 pediatric patients wit h aural polyps in an attempt to assess for clinical predictors of sign ificant otopathologic conditions. Chronic otitis media (43%), choleste atoma (29%), and retained tympanostomy tubes (23%) were the common cau ses. Unusual causes included mycobacterial infection and Langerhans' c ell histiocytosis. Multivariate analysis revealed the co-occurrence of conductive hearing loss at presentation to be a significant clinical predictor (P=.03) of cholesteatoma; the histopathologic finding of ker atin-induced giant cell reaction was nonspecific in this respect. Chol esteatoma was also prevalent in recurrent polyp cases, suggesting the need for prolonged follow-up in those children whose initial clinicopa thologic evaluation does not yield a definitive diagnosis.