[Fibro-adhesive otitis: nosology and treatment]

The term fibro-adhesive otitis is considered to correspond to filling of the middle ear with fibro-inflammatory tissue with an intact drum. When the fibrous tissue is very thin, that is to say when the mucosa is replaced by malpighian epithelium, the term epidermization or retraction pocket is preferred, this corresponding to different surgical problems, even though the roles of tubal insufficiency and seromucous otitis are probably the same in the etiology of fibro-adhesive otitis and epidermizations of the middle ear. Fibro-adhesive otitis presents as two different stages: a fibro-inflammatory phase in which the middle ear is filled with fibrous tissue and contains cystic spaces full of mucus; a fibro-adhesive phase when the whole middle ear is full of fibrous tissue and contains cholesterol granulomata but no cystic spaces. A study was conducted on 37 ears (8 at the fibro-inflammatory and 29 at the confirmed fibro-adhesive stage). Small cholesteatomas were associated in 15 ears and a posterior retraction pocket in 4. Results were frankly very poor for one-stage operations (exploration of the tympanic cavity with silastic and mastoidectomy (3 cases), tympanoplasty using a closed technique (1 case), and tympanoplasty using an open technique with obliteration (4 cases). Best results were obtained by a two-stage operation with prolonged inclusion of silastic between the two stages.(ABSTRACT TRUNCATED AT 250 WORDS)