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Cartilage palisade tympanoplasty in sinus and tensa retraction cholesteatoma
J Andersen1, P Cayé-Thomasen, M Tos
1Department of Otolaryngology, Gentofte University Hospital, Hellerup, Denmark.
Insights
The palisade cartilage technique effectively prevents eardrum retraction after cholesteatoma surgery in children. This method also maintained good postoperative hearing outcomes in pediatric patients.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Regenerative Medicine
Background:
- Cholesteatoma surgery in children often faces challenges with eardrum retraction.
- Eardrum reconstruction techniques aim to restore structural integrity and prevent complications.
Purpose of the Study:
- To evaluate the efficacy of the palisade cartilage technique in preventing eardrum retraction post-cholesteatoma surgery in pediatric patients.
- To assess the impact of this technique on postoperative hearing outcomes.
Main Methods:
- A cohort of 32 children (aged 5-15) with sinus or tensa retraction cholesteatoma underwent eardrum reconstruction using the palisade cartilage technique.
- Patients were followed for an average of 37 months, with evaluations including otomicroscopy, tympanometry, and audiometry.
Main Results:
- The palisade technique demonstrated high effectiveness in preventing eardrum retraction, with only two cases of minor retraction observed.
- All patients maintained an intact tympanic membrane, and no cholesteatoma recurrence was noted.
- Postoperative hearing levels were good and remained stable over the follow-up period.
Conclusions:
- The palisade cartilage technique is a successful method for preventing eardrum retraction following pediatric cholesteatoma surgery.
- This technique ensures favorable hearing results and structural integrity of the reconstructed eardrum.
Objective:
The aim of this study was to investigate whether reconstruction of the eardrum with palisade cartilage technique could prevent retraction of the new eardrum after surgery for sinus and tensa retraction cholesteatoma in children and to investigate the postoperative hearing.
Study Design:
In 32 children aged 5 to 15 years, operated on from June 1995 to October 2000 for cholesteatoma (21 with sinus cholesteatoma and 11 with tensa retraction cholesteatoma) the eardrum was reconstructed with the palisade cartilage technique. Postoperatively, the children were seen as outpatients and were recently reevaluated with otomicroscopy, tympanometry, and audiometry. All patients (100%) were reevaluated on an average of 37 months (range 3-63 months).
Main Outcome Measures:
Postoperative retractions, perforations, cholesteatoma recurrence, and hearing.
Results:
At the final examination, posterosuperior retraction was observed in two patients, both operated on for sinus cholesteatoma with reconstruction of the ossicular chain. In those cases, the palisades were not placed in the posterosuperior drilling defect behind the interpositioned incus. All the patients had an intact tympanic membrane at the final follow-up visit. One small perforation was surgically closed during the observation period. No patients developed cholesteatoma during the follow-up period. The postoperative hearing was good, and the hearing did not deteriorate with increasing observation time.
Conclusions:
The palisade technique effectively prevented postoperative retraction of the eardrum. The postoperative hearing was good.
