Long-term outcome of atticotomy for cholesteatoma in children

Ari DeRowe*, Gidon Stein, Gadi Fishman, Eli Berco, Shabtai Avraham, Roee Landsberg, Jacob Sadé

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Objective: To evaluate the long-term outcome of atticotomy (AT) surgery for cholesteatoma in children. Study Design: Case series, retrospective chart review. Setting: General otology practice in a teaching hospital. Patients: Fifty-three children aged 5 to 16 years old with cholesteatoma limited to the attic and middle ear who underwent AT between the years 1979 to 1994. Interventions: AT consisting of removal of cholesteatoma confined mainly to the attic. The procedure consists of removal of the lateral attic wall (scutum) and involved ossicles with excision of the cholesteatoma and tympanic membrane grafting with temporalis fascia, leaving a small attical cavity. The mastoid antrum was left intact. Main Outcome Measures: Disease recurrence, middle ear status, hearing results, and the need for further surgery. Results: Mean follow up was 5.1 (±3.6) years. Eleven (21%) children required completion canal wall down tympanomastoidectomy because of residual disease or recurrence. The mean preoperative speech recognition threshold was 39.4 ± 13.4 dB. The mean postoperative speech recognition threshold was 34.5 ± 15.4, an improvement of 6.1 dB compared with the preoperative level. Last follow-up examination revealed a dry ear in all cases but one. Conclusions: In selected cases, AT can be a less invasive option in children with cholesteatoma limited to the attic and middle ear.

Original languageEnglish
Pages (from-to)472-475
Number of pages4
JournalOtology and Neurotology
Issue number3
StatePublished - May 2005
Externally publishedYes


  • Atticotomy
  • Children
  • Cholesteatoma
  • Middle ear
  • Tympanomastoidectomy


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