Cholesteatoma in children, predictors and calculation of recurrence rates

The aim of the study was to evaluate the long-term recurrence rate after su rgery for acquired cholesteatoma in children, to search for predictors of r ecurrency and to analyse the impact of the applied statistical method on th e outcome of the results. During a 15-year period, 114 children underwent f irst-time surgery for acquired cholesteatoma. The patients were re-evaluate d with a median observation time of 5.8 years, range 1-16 years. Recurrence of cholesteatoma developed in 27 ears. The cumulated total recurrence rate was 24% using standard incidence rate calculation, applying Kaplan-Meier s urvival analysis the recurrence rate was 33%. Recurrent disease occurred si gnificantly more frequent in children < 8 years, with negative preoperative Valsalva, ossicular resorption and with large cholesteatomas. In conclusio n, young children with poor Eustachian tube function, large cholesteatoma a nd erosion of the ossicular chain, are at special risk of recurrence and sh ould be observed several years after surgery. (C) 1999 Elsevier Science Ire land Ltd. All rights reserved.