{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T22:42:38Z","timestamp":1778625758941,"version":"3.51.4"},"reference-count":34,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science (JSPS) KAKENHI","doi-asserted-by":"publisher","award":["JP20K18316"],"award-info":[{"award-number":["JP20K18316"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The development of temporal bone pneumatization is related to the postnatal middle ear environment, where the development of air cells is suppressed with otitis media in early childhood. However, whether air cell formation restarts when mastoidectomy is performed during temporal bone pneumatization remains unclear. Herein, we evaluated temporal bone pneumatization after canal wall up (CWU) tympanomastoidectomy for middle ear cholesteatoma in children. Methods: In total, 63 patients, including 29 patients with congenital cholesteatoma (CC) and 34 patients with acquired cholesteatoma (AC), were assessed using a set of pre- and postoperative computed tomography images. The air cells of the temporal bone were divided into five areas: periantral (anterior), periantral (posterior), periantral (medial), peritubal, and petrous apex. The number of areas with air cells before and after surgery was compared to evaluate temporal bone pneumatization after surgery. Results: A total of 63 patients, comprising 29 with CC and 34 with AC (pars flaccida; 23, pars tensa; 7, unclassified; 4), were evaluated. The median age of patients (18 males and 11 females) with CC was 5.0 (range, 2\u201315 years), while that of the AC group (23 males and 11 females) was 8 (range, 2\u201315 years). A significant difference in air cell presence was identified in the CC and AC groups after surgery (Mann\u2013Whitney U, p &lt; 0.001 and p = 0.003, respectively). Between the two groups, considerably better postoperative pneumatization was observed in the CC group. A correlation between age at surgery and gain of postoperative air cell area development was identified in the CC group (Spearman\u2019s rank-order correlation coefficient, r = \u22120.584, p &lt; 0.001). In comparison with the postoperative pneumatization rate of each classified area, the petrous apex area was the lowest in the CC and AC groups. Conclusions: Newly developed air cells were identified in the temporal bones after CWU mastoidectomy for pediatric cholesteatoma. These findings may justify CWU tympanomastoidectomy, at least for younger children and CC patients, who may subsequently develop air cell systems after surgery.<\/jats:p>","DOI":"10.3390\/jcm13102934","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T06:44:31Z","timestamp":1715841871000},"page":"2934","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Development of Air Cell System Following Canal Wall Up Mastoidectomy for Pediatric Cholesteatoma"],"prefix":"10.3390","volume":"13","author":[{"given":"Yusuke","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, International University of Health and Welfare, Tochigi 324-8501, Japan"},{"name":"Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2800-8886","authenticated-orcid":false,"given":"Akira","family":"Ganaha","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan"},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, International University of Health and Welfare, Narita Hospital, Chiba 286-0124, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nao","family":"Nojiri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, International University of Health and Welfare, Tochigi 324-8501, Japan"},{"name":"Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4435-8046","authenticated-orcid":false,"given":"Takashi","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7577-7728","authenticated-orcid":false,"given":"Kuniyuki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Tono","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, International University of Health and Welfare, Tochigi 324-8501, Japan"},{"name":"Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1177\/000348946907800105","article-title":"Pneumatization of the temporal bone","volume":"78","author":"Allam","year":"1969","journal-title":"Ann. 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