Objective
To review the characteristics of congenital cholesteatomata.
Design
Case series.
Setting
Tertiary care (referral-based) private practice.
Patients and Other Participants
Fourteen patients were included in the study. The diagnosis of congenital cholesteatoma was based on an intact tympanic membrane on physical examination; a history that excluded tympanic membrane perforation, otorrhea, or previous otologic procedure; and a documented cholesteatoma at the time of surgical removal.
Intervention
Surgical procedures including tympanotomy, atticotomy, and tympanotomy with mastoidectomy were performed on all patients.
Main Outcome Measures
Removal of cholesteatoma.
Results
Four of the 14 patients had lesions isolated to the anterosuperior quadrant of the tympanum; the remainder had more extensive disease with notable posterior tympanic involvement. Three of the patients underwent surgery for recidivism; none were from isolated anterior lesions. One of these patients was referred at the time of recurrence, one had known residual cholesteatoma, and one had recurrence.
Conclusions
Clinical presentation and surgical findings enable the differentiation of two separate sites of congenital cholesteatoma formation: the anterosuperior and posterior-superior regions of the tympanic cavity. Recidivism of the lesion appears more commonly with posterior-superior congenital cholesteatomas.
(Arch Otolaryngol Head Neck Surg. 1995;121:19-22)
