Clinical experience of 71 cases of congenital middle ear cholesteatoma.

Conclusions: As congenital middle ear cholesteatoma (CMC) is a different disease entity from acquired cholesteatoma, early diagnosis is important for good treatment results. Preoperative computed tomography (CT) imaging is a useful modality for both evaluation of the extent of the disease and selection of appropriate surgical methods. Some modification should be considered based on the findings of the actual operative field for complete removal of CMC.

Objectives: To present the results of surgical treatment of 71 cases of CMC and investigate the applicability of preoperative CT for the treatment of CMC.

Patients And Methods: A retrospective study over an 11-year period was performed. The presenting symptoms, tympanic membrane findings, surgical findings, methods, and results were investigated retrospectively.

Results: CMC was found incidentally in 38 cases (53.5%). A whitish mass medial to the tympanic membrane was observed in 62 cases (87%). Postoperative air-bone gap changes were not statistically significant. There was no predominance of localized lesions of the middle ear. The recurrence rate was 9.9% (seven cases), and higher in open type. Staging by CT and surgical staging matched in 70.4%. Positive predictive value for mastoid involvement of CT staging was 72.7%, with sensitivity and specificity of 68.6% and 87.5%, respectively.