Treatment and Efficacy of Pediatric Hidden Tympanic Cholesteatoma Pearl Under Ear Endoscopy

YANG Quyang; WANG Xiaodong; XU Ying

doi:10.3969/j.issn.1004-437X.2026.06.013

Abstract：Objective To investigate and analyze the clinical characteristics,diagnosis,treatment,and surgical outcomes of pediatric hidden tympanic cholesteatoma pearls,providing clinical reference for the management of this rare condition.Methods A retrospective analysis was conducted of 17 pediatric patients diagnosed with hidden tympanic cholesteatoma who underwent treatment at the Department of Otorhinolaryngology,Head and Neck Surgery of Children's Hospital Affiliated of Zhengzhou University,from 2020 to 2025.Among them,13 were male and 4 were female,with a mean age of 4.1 years.The disease location,duration,clinical manifestations,imaging findings,and surgical outcomes were summarized.Results All 17 patients underwent transcanal endoscopic excision of the cholesteatoma pearls.During follow-up periods ranging from 0.5 to 3 years,no recurrence of cholesteatoma was observed under postoperative otoscopic examination.The tympanic membranes were well healed,and the tympanic cavities demonstrated good aeration.Hearing follow-up showed that all 10 patients with normal preoperative hearing and 6 patients with preoperative conductive hearing loss recovered to normal hearing levels postoperatively.One patient with concomitant enlarged vestibular aqueduct showed no hearing improvement.Among 6 patients who presented with type As tympanograms before surgery,all demonstrated normalization of tympanograms after the procedure.Conclusion Endoscopic transcanal tympanotomy with cholesteatoma pearl excision is an effective and minimally invasive surgical approach for pediatric hidden tympanic cholesteatoma pearls.The procedure is technically feasible,achieves satisfactory therapeutic outcomes,and merits broader clinical application.Early detection,diagnosis,and intervention are crucial to ensure favorable prognoses for children with tympanic cholesteatoma.