Canal wall-down procedure with soft posterior meatal wall reconstruction in acquired cholesteatoma: focus on postoperative middle ear status*. (3rd August 2018)

• Record Type: Journal Article
• Authors: Tachibana, Tomoyasu; Kariya, Shin; Orita, Yorihisa; Nakada, Michihiro; Makino, Takuma; Komatsubara, Yasutoshi; Matsuyama, Yuko; Naoi, Yuto; Nishizaki, Kazunori
• Is Part Of: Acta oto-laryngologica. Volume 138:Number 8(2018)
• Page Start: 695
• Page End: 700
• Publication Date: 2018-08-03
• Subjects: Acquired cholesteatoma -- canal wall-down tympanoplasty with soft posterior meatal wall reconstruction -- surgical outcomes -- residual cholesteatoma -- postoperative deep retraction pocket; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2018.1439593
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: 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.