TY - JOUR
T1 - Canal wall-down procedure with soft posterior meatal wall reconstruction in acquired cholesteatoma
T2 - focus on postoperative middle ear status*
AU - Tachibana, Tomoyasu
AU - Kariya, Shin
AU - Orita, Yorihisa
AU - Nakada, Michihiro
AU - Makino, Takuma
AU - Komatsubara, Yasutoshi
AU - Matsuyama, Yuko
AU - Naoi, Yuto
AU - Nishizaki, Kazunori
N1 - Publisher Copyright:
© 2018, © 2018 Acta Oto-Laryngologica AB (Ltd).
PY - 2018/8/3
Y1 - 2018/8/3
N2 - Objectives: We reviewed surgical results of canal wall-down tympanoplasty (CWDT) with soft posterior meatal wall reconstruction (SWR) for acquired cholesteatoma (AC), and identified factors associated with surgical outcomes. Methods: Results from 119 ears with AC (pars flaccida, n = 99; pars tensa, n = 20) that underwent CWDT with SWR were retrospectively reviewed. We defined postoperative balloon-like retraction (PBR) with web formation, which needed reoperation to clean accumulated cerumen, as postoperative deep retraction pocket (PDRP). Results: Residual cholesteatoma was found in 11 ears (9.2%). Seven residual cholesteatomas were treated with outpatient operation. Seven ears (5.9%) showed PDRP. A transcanal approach was applied to all PDRPs. Postoperative mastoid reaeration was observed in 57 ears (47.9%). No factors significantly associated with residual cholesteatoma or PDRP were identified. The frequency of postoperative mastoid reaeration was significantly higher among cases with young age (<50 years), stage I cholesteatoma, or type I ossiculoplasty. Conclusion: CWDT with SWR showed low rates of residual cholesteatoma or postoperative deep retraction pocket (PDRP). Most residual cholesteatomas and PDRPs could be dealt with using a minimally invasive procedure. Young age, stage I cholesteatoma, and type I ossiculoplasty were associated with postoperative mastoid reaeration. This procedure seems fully feasible for surgical treatment of AC.
AB - Objectives: We reviewed surgical results of canal wall-down tympanoplasty (CWDT) with soft posterior meatal wall reconstruction (SWR) for acquired cholesteatoma (AC), and identified factors associated with surgical outcomes. Methods: Results from 119 ears with AC (pars flaccida, n = 99; pars tensa, n = 20) that underwent CWDT with SWR were retrospectively reviewed. We defined postoperative balloon-like retraction (PBR) with web formation, which needed reoperation to clean accumulated cerumen, as postoperative deep retraction pocket (PDRP). Results: Residual cholesteatoma was found in 11 ears (9.2%). Seven residual cholesteatomas were treated with outpatient operation. Seven ears (5.9%) showed PDRP. A transcanal approach was applied to all PDRPs. Postoperative mastoid reaeration was observed in 57 ears (47.9%). No factors significantly associated with residual cholesteatoma or PDRP were identified. The frequency of postoperative mastoid reaeration was significantly higher among cases with young age (<50 years), stage I cholesteatoma, or type I ossiculoplasty. Conclusion: CWDT with SWR showed low rates of residual cholesteatoma or postoperative deep retraction pocket (PDRP). Most residual cholesteatomas and PDRPs could be dealt with using a minimally invasive procedure. Young age, stage I cholesteatoma, and type I ossiculoplasty were associated with postoperative mastoid reaeration. This procedure seems fully feasible for surgical treatment of AC.
KW - Acquired cholesteatoma
KW - canal wall-down tympanoplasty with soft posterior meatal wall reconstruction
KW - postoperative deep retraction pocket
KW - residual cholesteatoma
KW - surgical outcomes
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U2 - 10.1080/00016489.2018.1439593
DO - 10.1080/00016489.2018.1439593
M3 - Article
C2 - 29519185
AN - SCOPUS:85043325579
VL - 138
SP - 695
EP - 700
JO - Acta Oto-Laryngologica
JF - Acta Oto-Laryngologica
SN - 0001-6489
IS - 8
ER -