Clinical Characteristics and Diagnosis and Treatment Analysis of Middle Ear Cholesteatoma Complicated with Intracranial Complications in Children
QIAN Enle
REN Hongbo
LIU Wei
DUAN Qingchuan
YANG Weiguang
CAI Fangyu
HAN Fugen
ZHANG Jie
Abstract：Objective This paper focuses on clinical characteristics and key factors in diagnosis and treatment of middle ear cholesteatoma with intracranial complications in children.Methods Three cases of middle ear cholesteato-ma with intracranial complications treated at Henan Children's Hospital and Beijing Children's Hospital,Capital Medi-cal University,from June 2020 to February 2023 were reported,including clinical manifestations,treatment methods and outcomes.Results The cases included 1 boy and 2 girls.Clinical presentation included ear discharge and signs of meningitis with fever and headaches.One patient experienced severe mental state changes with projectile vomiting.Head CT and MRI,as well as temporal bone CT,revealed epidural abscess in 2 cases and cerebellar abscess in 1 case.Empiric antibiotics,multidisciplinary consultation and management of high fever,headaches,vomiting and conscious-ness changes were implemented while the individualized perioperative plan was developed.Radical mastoidectomy was performed under general anesthesia facilitated by a neurosurgeon for intracranial lesions,followed by targeted antibiot-ics based on culture and drug sensitivity test.Complete recovery was achieved in all three patients with no recurrence during follow-ups.Conclusion Intracranial complications should be suspected in children with middle ear cholesteato-ma showing high fever and headaches.Timely head CT and MRI evaluation and multidisciplinary consultation can facil-itate perioperative management.Canal wall-down mastoidectomy for lesion removal and unobstructed drainage is the treatment of choice once the patient is stabilized.
Keywords：childrenmiddle ear cholesteatomaintracranial complicationsdiagnosistreatment
Publication Date：2024-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 66-71 )