{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:19:24Z","timestamp":1777421964222,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2005,7,1]],"date-time":"2005-07-01T00:00:00Z","timestamp":1120176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2005,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To determine the factors associated with the diagnosis of acquired cholesteatoma (AC) in children, we performed a retrospective chart review at a tertiary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We reviewed children with a diagnosis of AC that extended beyond the mesotympanum in the presence of a nonintact tympanic membrane who underwent surgical treatment over a 14-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 116 children (78 male, 38 female) between 3 and 18 years of age (mean, 9.5 years). Their average period of management in a specialist otolaryngology clinic before the diagnosis of cholesteatoma was made was 3.2 years, and 68% of the children had previously undergone insertion of tympanostomy tubes. Symptoms and signs included chronic otorrhea (59%), recurrent acute otitis media (58%), and conductive hearing loss (51%). The diagnosis of AC was eventually made after office otoscopy (26%), temporal bone computed tomography (24%), or examination under anesthesia (17%). In 33% of children, the diagnosis was made only after surgical exploration of the middle ear and mastoid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our data underscore the importance of maintaining a high index of suspicion for AC in managing children with long-standing otologic symptoms, and considering otomicroscopy, computed tomographic scanning, or tympanomastoid exploration if medical treatment fails.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/000348940511400708","type":"journal-article","created":{"date-parts":[[2014,10,3]],"date-time":"2014-10-03T14:40:52Z","timestamp":1412347252000},"page":"539-542","source":"Crossref","is-referenced-by-count":7,"title":["Extensive Acquired Cholesteatoma in Children: When the Penny Drops"],"prefix":"10.1177","volume":"114","author":[{"given":"Craig W.","family":"Semple","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murali","family":"Mahadevan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert G.","family":"Berkowitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2005,7,1]]},"reference":[{"key":"bibr1-000348940511400708","first-page":"513","volume-title":"Pediatric otolaryngology","author":"Bluestone CD","year":"1983"},{"key":"bibr2-000348940511400708","volume-title":"Ear nose and throat disorders in children","author":"Bordley JE","year":"1986"},{"key":"bibr3-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/160.1.83"},{"key":"bibr4-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1080\/00016489950180801"},{"key":"bibr5-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(00)00407-9"},{"key":"bibr6-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198110000-00021"},{"key":"bibr7-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1977.00780190054003"},{"key":"bibr8-000348940511400708","first-page":"189","volume":"4","author":"Tos M","year":"1983","journal-title":"Am J Otol"},{"key":"bibr9-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1978.tb00720.x"},{"key":"bibr10-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100107121"},{"key":"bibr11-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5876(87)90020-6"},{"key":"bibr12-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2001.113941"},{"key":"bibr13-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198109000-00006"},{"key":"bibr14-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1017\/S002221510010711X"},{"key":"bibr15-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100099606"},{"key":"bibr16-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5876(92)90017-J"},{"key":"bibr17-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.2002.00538.x"},{"key":"bibr18-000348940511400708","first-page":"121","volume":"23","author":"Garber LZ","year":"1994","journal-title":"J Otolaryngol"},{"key":"bibr19-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(02)00373-7"},{"key":"bibr20-000348940511400708","doi-asserted-by":"publisher","DOI":"10.1258\/002221503321892280"},{"key":"bibr21-000348940511400708","first-page":"155","volume":"42","author":"Chee NW","year":"2001","journal-title":"Singapore Med J"},{"key":"bibr22-000348940511400708","first-page":"369","volume":"45","author":"Sneyers W","year":"1991","journal-title":"Acta Otorhinolaryngol Belg"},{"key":"bibr23-000348940511400708","first-page":"22","volume":"57","author":"Twemlow S","year":"1991","journal-title":"Radiogr Today"}],"container-title":["Annals of Otology, Rhinology &amp; 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