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European Archives of Oto-Rhino-Laryngology

Erschienen in:

30.09.2023 | Otology

Acquired cholesteatoma after cochlear implants: case series and literature review

verfasst von: Vittoria Sykopetrites, Flavia Di Maro, Eleonora Sica, Eliana Cristofari

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 3/2024

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Abstract

Purpose

To assess the prevalence and management of acquired cholesteatoma after cochlear implantation in pediatric and adult patients.

Methods

Retrospective case review of pediatric and adult cochlear implants (CI) followed at a tertiary referral center and literature review of acquired cholesteatoma after CI surgery, to identify its prevalence, cause, and treatment.

Results

Nine pediatric CIs were diagnosed with cholesteatoma in seven patients after 6.4 ± 4 years from CI surgery, and two adults after 11.3 and 21.7 years from CI surgery. Thirty-four pediatric cases and 26 adult cases are described in the literature. Cholesteatoma has a prevalence of 0.54% in pediatric CIs, and 1.79% in adult CIs (case series and literature). Adult cases were diagnosed significantly later compared to pediatric cases (Mann–Whitney test, p = 0.0460). Three pediatric cholesteatomas were treated with conservative surgery and preservation of the CI; they all developed recurrent disease. The remaining pediatric cases underwent subtotal petrosectomy with simultaneous CI explantation and staged reimplantation. Only one case recurred. The adult cases underwent simultaneous subtotal petrosectomy, explantation, and reimplantation. Similarly, 33.3% of cases treated with conservative/reconstructive surgery in the literature required revision surgery or conversion to subtotal petrosectomy against 6.2% of subtotal petrosectomies in the literature.

Conclusions

Cholesteatoma after CI is a rare and late-onset complication of CIs. It is more prevalent in the adult CI population, although it affects children significantly earlier. The treatment of choice is subtotal petrosectomy and CI explantation with simultaneous or staged reimplantation.

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Titel: Acquired cholesteatoma after cochlear implants: case series and literature review
verfasst von: Vittoria Sykopetrites
Flavia Di Maro
Eleonora Sica
Eliana Cristofari
Publikationsdatum: 30.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 3/2024
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-023-08251-y

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Acquired cholesteatoma after cochlear implants: case series and literature review