Manejo clinicoquirúrgico de la otitis media crónica colesteatomatosa en el ni？o

the treatment of in children is controversial and difficult. we proposed ourselves to characterize pediatric patients with extensive cholesteatomas and active infection, as well as to identify otoscopic and surgical findings, complications, microbiology, efficiency of the antimicrobial treatment and functional auditive affections. a descriptive and prospective study was conducted among 12 patients aged 4-15 that were operated on by open technique combined with tympanoplasty and ossiculoplasty from 2001 to 2004. the evolution of the patients was followed during 3 years after surgery. the most common findings were posterior marginal epytimpanic perforation (41.6 %), total ossicular injury (50 %), tympanic facial dehiscence and erosion of the horizontal semicircular canal (45.4 %). the intratemporal complications were the most frequent (50 %). timpano-ossicular reconstruction was performed in 8 patients, and the hearing results were satisfactory in 66.6 %, whereas the response to the antimicrobial agent used was efficient in 100 % of the cases. the use of the open surgical technique together with a correct antibiotic strategy is what is indicated in children with extensive cholesteatomas and active infection.