Atelectasis. Retraction Pockets and Cholesteatoma

Sadé, Jacob; Avraham, Shabtai; Brown, Monique L.

doi:10.3109/00016488109133289

Cited by 94 publications

(75 citation statements)

References 3 publications

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“…In our series, at the time of surgery there was a high incidence of cholesteatoma, 13 out of 42 (31 %), which all occurred in stage III retractions. Sade et al [6] found that in both pars tensa and pars flaccida regions, 2 % of untreated retractions developed cholesteatoma during an average 3 year follow up period. Similar rates of cholesteatoma of between 1 and 4 % were reported by Kokko and Tos [7,19].…”

Section: Discussionmentioning

confidence: 99%

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The Surgical Management of Tympanic Membrane Retraction Pockets Using Cartilage Tympanoplasty

Kasbekar¹,

Patel²,

Rubasinghe³

et al. 2014

Indian J Otolaryngol Head Neck Surg

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Evaluate the surgical treatment of tympanic membrane (TM) retractions with modified cartilage augmentation tympanoplasty. Retrospective review of subjects with Charachon stage II and III TM retractions who underwent modified cartilage augmentation tympanoplasty following excision of the retracted TM segment. Pre and postoperative symptoms and air-bone gaps were recorded. Forty two ears were included in the study. Twenty six ears were of stage II and 16 were stage III retractions. 35 (83 %) ears had ossicular erosion and cholesteatoma was found in 13 (31 %) ears, all in stage III retractions. Follow-up ranged 12-102 months. The air-bone gap (ABG) improved in 29 (76 %) and worsened in seven (19 %). Ears without cholesteatoma had a greater improvement in ABG. The results of our modified cartilage tympanoplasty technique are comparable to the published literature and should provide a safe and acceptable result. The high rate of cholesteatoma found preoperatively in stage III retractions advocates early surgical intervention.

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Section: Discussionmentioning

confidence: 99%

“…Sade et al [6] found that in both pars tensa and pars flaccida regions, 2 % of untreated retractions developed cholesteatoma during an average 3 years follow up period. In cases of patients with OME treated with ventilation tube insertion with or without adenoidectomy, between 1 and 4 % of ears developed attic cholesteatoma [7].…”

Section: Introductionmentioning

confidence: 99%

The Surgical Management of Tympanic Membrane Retraction Pockets Using Cartilage Tympanoplasty

Kasbekar¹,

Patel²,

Rubasinghe³

et al. 2014

Indian J Otolaryngol Head Neck Surg

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“…This lends itself to use by nurse practitioners or allied health professionals who can photograph the retraction enter it into the database, carry out the classification and arrange audiometry. This is likely to be more effective for monitoring retractions over longer periods as only 10 to 20 per cent will progress [1]. Any changes detected can then be notified to the surgeon.…”

Section: Discussionmentioning

confidence: 99%

“…The number of classifications itself suggests that there has not been general satisfaction with any one type. Certainly the traditional Sade classification demonstrates the progression of retraction but not specifically where in the pars tensa it is occurring and can therefore be regarded as more pathophysiological than anatomical [1]. When trying to analyse the effect of treatment on retractions, in particular elevation in children with middle ear effusions at the time of grommet insertion, it was found that the current classifications could not demonstrate small changes of improvement.…”

Section: Introductionmentioning

confidence: 99%

A Working Classification of Retraction for the Whole Tympanic Membrane

Barr¹

2013

IJOHNS

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Objective: To formulate a reliable classification of tympanic membrane retraction which is easy to use but capable of detecting small differences in retraction. Study Design: Prospective study. Methods: The classification was developed from observations dividing the drum into 3 areas: the pars tensa anterior to the malleus, type I, posterior to the malleus (subdivided into upper and lower) type II, and attic type III. The subclassification on paper is more complicated but using a database it is easy to use. The classification is automatically calculated by the database which can also be converted to numerical form. The classification also allows documentation of active disease in retractions. Photographs of seven retracted ear drums were incorporated into the database and ten otolaryngologists asked to classify them. Five were asked to reclassify the retractions in the same way after 3 months. Results: Intra class correlation was significantly high (>0.9) for pars tensa, attic, and for bony erosion. Cronbach's alpha values were also high (>0.9) in all groups. Retest values were evaluated with Wilcoxon's signed rank sum test establishing that there was no significant difference in results. Conclusion: The classification shows reliabiliy and validity allowing detection of small changes in tympanic membrane retraction especially affecting the pars tensa but allows classification of the whole tympanic membrane.

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“…In another study of 39 patients with grade III atelectasis, most ears improved or remained stable without treatment, while roughly 10% deteriorated, possibly leading to cholesteatoma formation. 9 In a review of his experience with 520 atelectatic ears including retraction pockets, Sadé 10 reported the eventual deterioration to cholesteatoma in 2% to 10% of ears. In addition to the risk of cholesteatoma, adhesion of the TM alone may lead to erosion of the ossicles.…”

Section: Introductionmentioning

confidence: 99%

Does Early Surgical Intervention of Middle Ear Atelectasis Improve Long-term Results and Prevent Cholesteatoma?

Saunders¹

2008

Arch Otolaryngol Head Neck Surg

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Atelectasis. Retraction Pockets and Cholesteatoma

Cited by 94 publications

References 3 publications

The Surgical Management of Tympanic Membrane Retraction Pockets Using Cartilage Tympanoplasty

The Surgical Management of Tympanic Membrane Retraction Pockets Using Cartilage Tympanoplasty

A Working Classification of Retraction for the Whole Tympanic Membrane

Does Early Surgical Intervention of Middle Ear Atelectasis Improve Long-term Results and Prevent Cholesteatoma?

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