Updates in Pediatric Cholesteatoma: Minimizing Intervention While Maximizing Outcomes

Abstract

Advances in pediatric otology have provided new tools to diagnose and manage complex otologic disease. Diffusion-weighted MRI provides the surgeon with a tool to detect recurrent or residual cholesteatoma that may obviate a second look surgery. Surgical trends move toward less invasive surgery. The literature provides good evidence to advocate for preserving the posterior ear canal and single stage ossiculoplasty. The growing popularity and increasing evidence in the literature supports otoendoscopy as a means to minimize invasiveness while eradicating disease in previously difficult to reach anatomic locations. These advances have allowed the otologic surgeon to improve surgical outcomes while minimizing intervention.

Keywords: Cholesteatoma; Diffusion weighted MRI; Endoscopy; Eustachian tube dysfunction; Mastoidectomy; Ossiculoplasty; Otitis media with effusion.