ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG Ở BỆNH NHÂN CHOLESTEATOMA TAI GIỮA BẨM SINH VÀ MẮC PHẢI

Abstract

Objectives: To describe and compare the clinical and paraclinical characteristics of patients with congenital and acquired middle ear cholesteatoma. Methods: A cross-sectional descriptive study was conducted on 121 patients (80 acquired and 41 congenital cases). Clinical manifestations, hearing characteristics, and temporal bone computed tomography (CT) findings were analyzed and compared between the two groups. Results: Congenital cholesteatoma was predominantly observed in children aged 3 to < 7 years, whereas acquired cases were mainly found in patients aged ≥13 years. The congenital group presented with subtle clinical manifestations (hearing loss, tinnitus, and otalgia each accounting for 9.76%), while the acquired group showed more pronounced symptoms, including hearing loss (92.5%), tinnitus (78.75%), and otorrhea (72.5%); p < 0.01. Normal hearing was predominant in the congenital group (70.73%), whereas 95.0% of acquired cases exhibited hearing loss, predominantly conductive; an air-bone gap (ABG) > 40dB was more frequently observed in the acquired group (p < 0.01). On CT imaging, lesions were mainly located in the epitympanum (> 90%) in both groups, with no significant difference. However, mastoid pneumatization differed significantly: Well-pneumatized mastoids were predominant in the congenital group (75.6%), while sclerotic mastoids were more common in the acquired group (81.3%); p < 0.01. Conclusion: Congenital and acquired cholesteatomas differ markedly in clinical presentation, hearing characteristics, and mastoid pneumatization on CT imaging. These factors are highly valuable for differential diagnosis and treatment planning.