Related Experiment Videos
Eustachian tube dysfunction in the pathogenesis of cholesteatoma: clinical considerations
W Y Chao1, H Z Tseng, S J Chang
1Department of Otolaryngology, National Cheng Kung University, College of Medicine, Tainan, Taiwan.
Objective:
This study was conducted to gain insight into the surgical management of cholesteatomas to prevent postoperative retraction of the tympanic membrane.
Design:
A retrospective chart review of patients presenting between July 1988 and July 1992 was conducted.
Method:
Clinical observations were made on 85 ears from 81 patients who had tympanoplasty with mastoidectomy for middle ear cholesteatoma, with ossicular reconstruction if necessary, with a subsequent follow-up period of 36 to 84 months (mean, 60 +/- 13 months).
Results:
The tympanic membrane in several cases became gradually retracted postoperatively; retraction generally commenced along the margin of the cartilage used for repairing the scutum defect, and was noted as early as 9 months, and after 5 years' follow-up, in as much as 66% in the 44 ears operated.
Conclusions:
Eustachian tube dysfunction was common postoperatively in cholesteatomatous ears; however, whether it was the etiology or the sequela of a cholesteatoma could not be deduced. Since a retraction pocket in the tympanic membrane can develop into a cholesteatoma, it may account for some cases with recurrence of cholesteatoma postoperatively. Therefore, the cartilage/perichondrium composite graft for repairing the bone defect should be as large as possible.