Cholesteatomas in Greenlandic Inuit. A retrospective study and follow-up of treated cases from 1976-91

Abstract

Chronic otitis media is frequent among the Inuit in Greenland, but reports of cholesteatomas are rare. To describe cholesteatoma in Greenland, we have performed a retrospective study and follow-up of Greenlandic Inuit treated at the ENT-department, Rigshospitalet, Denmark in the period 1976-91. We found 35 Greenlandic Inuit with cholesteatoma, the first in 1976. Median age was 19 years. The total incidence was calculated to 5 per 100.000 per year, or 2 new cases per year. The geographical distribution showed less cholesteatomas among the people with a traditional way of life in the Hunter region. The complication rate was 11%. The extension and pathology of the cholesteatomas indicated late and infrequent contact with an ENT specialist. The follow-up study revealed 53% dry ears with intact tympanic membrane, and 47% with intermittent ear discharge. Residual or recurrent cholesteatoma was found in 46% of the patients, less frequently when the primary operation included mastoidectomy with canal wall-down technique. We recommend this operation in most Greenlandic Inuit with cholesteatomas.