Classification and surgical treatment of fibroadhesive otitis

Surgical treatment for fibroadhesive otitis was performed in thirty-seven ears: eight were classified grade 1, with fibrogranulomatous tissue and mucous effusion; twenty-seven were stage 2, with thick fibrogranulomatous tissue without effusion but with cholesterol granuloma. Fifteen ears had small or middle size cholesteatomas, four had posterior retraction pockets. Results obtained were as follow. One stage procedures were usually functional failures in spite of Silastic sheeting, including one tympanoplasty using closed technique with posterior tympanotomy, three dissections of mesotympanum combined with antroatticotomy, and four obliteration procedures in one stage. Better results were obtained with two stage procedures with Silastic sheeting placed at the first stage and removed at the second. Five closed techniques yielded only one good functional result, but seventeen obliteration procedures with Palva flaps yielded the best results: healthy and thin mucosa in fifteen cases, with the mucosa remaining thick in only two cases. Good functional results (air-bone gap less than or equal to 20 dB) were obtained in ten cases, and among them very good functional results (air-bone gap less than or equal to 10 dB) in seven cases. Seven second stages have not yet been done.