How to treat cholesteatoma of the external auditory canal in children

For parents, their children's illness is a cause of worry. External auditory canal cholesteatoma is a disease that can occur in people of many ages. Children may also suffer from this disease, and parents will be worried and anxious at this time because they don’t know how to treat this disease. So, how to treat cholesteatoma in the external auditory canal in children? Let me introduce it to you below, I hope it will be helpful to you.

Instrumental removal

For cholesteatoma that does not completely block the external auditory canal, an earwax hook can be slowly inserted along the wall of the external auditory canal into the inside of the cholesteatoma to hook it out. Since the posterior superior wall has the least sensitivity among the walls of the external auditory canal, the cholesteatoma can be removed from the posterior superior wall first. This method is not suitable for children with cholesteatoma masses close to the tympanic membrane or who cannot cooperate, so as to avoid damaging the external auditory canal and other important structures of the middle ear.

External ear canal irrigation

If the cholesteatoma is hard and difficult to remove with instruments, you can first use 3%-5% sodium bicarbonate solution or boric acid glycerin ear drops 3-4 times a day. After 3 days, use an irrigator to rinse the softened cholesteatoma once or several times. Note when flushing: Do not use it if you have acute or chronic suppurative otitis media or other tympanic membrane perforation; the flushing solution should be close to body temperature; too cold or too hot may cause labyrinth irritation symptoms and lead to dizziness in the patient; the direction of flushing must be obliquely towards the posterior and superior wall of the external auditory canal; if it is directly towards the tympanic membrane, it may cause tympanic membrane damage; if it is directly towards the foreign body, it may be flushed deep into the external auditory canal and become more difficult to remove. For those with concurrent infection, anti-inflammatory treatment should be given first. 3% boric acid glycerol or 4% phenol glycerol can be dripped several times a day. If necessary, antibiotics can be taken orally or intravenously, and the treatment can be resumed after 3 to 4 days when the inflammation is under control. However, it is difficult to completely control inflammation alone. According to experience, it is best to control the infection while gradually removing the cholesteatoma in stages.

Endoscopic or surgical microscope removal under general anesthesia

This method can be considered for patients with severe infection and difficulty in removal. At the same time, systemic antibiotics are used to control infection. Follow-up observation is required after the operation, and any residual or regenerated cholesteatoma should be cleaned up at any time.

Radical mastoidectomy and tympanoplasty surgery

Patients with external auditory canal cholesteatoma invading the mastoid and/or middle ear should undergo radical mastoidectomy and tympanoplasty. The principle of surgery is to completely remove cholesteatoma tissue and destroyed dead bone, expand the external auditory canal, and restore hearing. Thorough cleaning of the external auditory canal floor is the key to avoiding recurrence. Under local or general anesthesia, an incision is made inside or behind the ear, and cholesteatoma removal is performed under a microscope. At the same time, conchaplasty and tympanoplasty are performed according to different lesions. The dressing was changed after surgery until the surgical cavity was completely epithelialized.

The above content is very helpful for parents of children with external auditory canal cholesteatoma. At the same time, parents are reminded that if their children are sick, they must not be too anxious. Instead, they should use the correct methods so that no other problems arise during treatment. It is best to ensure that their children are healthy and happy.