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Shall we resect the tip of manubrium mallei in tympanoplasty?
Ahmet Kutluhan1, Gökhan Yalçıner, Gülnur Güler
1Department of ENT, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
Objectives:
In tympanoplasty operations if perforation is related with malleus handle, malleus handle is desepithelised. We planned this research to investigate whether the epithelial remnants remain as a result of this desepithelisation or not.
Methods:
The 35 patients who were performed tympanoplasty operation were divided into two groups. In the first group which included 13 patients the tip portion of manubrium mallei were cut off without desepithelisation. In the second group which included 22 patients the tip portions of manubrium mallei were cut off after the meticulous desepithelisation. The presence of squamous epithelium was examined histopathologically on the specimens.
Results:
Squamous epithelium was observed in 9 of the 13 non-desepithelised specimens and in 6 of 22 desepithelised specimens.
Conclusion:
In tympanoplasty operations despite careful desepithelisation, squamous epithelial remnants may remain on the malleus handle. So the tip of manubrium mallei could be resected to prevent the future development of cholesteatoma.
Insights
Even with careful cleaning, epithelial remnants can persist on the malleus handle after tympanoplasty. Resecting the malleus tip may prevent future cholesteatoma development.
Area of Science:
- Otolaryngology
- Surgical Pathology
Background:
- Tympanoplasty involves desepithelialization of the malleus handle when perforation is present.
- The persistence of epithelial remnants after this procedure is not fully understood.
Purpose of the Study:
- To investigate the presence of epithelial remnants on the malleus handle after desepithelialization during tympanoplasty.
- To determine if these remnants contribute to post-operative complications.
Main Methods:
- A comparative study of 35 tympanoplasty patients.
- Group 1 (13 patients): Malleus tip resected without desepithelialization.
- Group 2 (22 patients): Malleus tip resected after meticulous desepithelialization.
- Histopathological examination of specimens for squamous epithelium.
Main Results:
- Squamous epithelium was found in 9 of 13 non-desepithelialized specimens.
- Squamous epithelium was observed in 6 of 22 desepithelialized specimens.
Conclusions:
- Squamous epithelial remnants can remain on the malleus handle despite careful desepithelialization during tympanoplasty.
- Resection of the malleus tip may be a strategy to prevent cholesteatoma formation.
