Retraction pockets of pars tensa in pediatric patients: Clinical evolution and treatment

The status of the contralateral ear in children with acquired cholesteatoma

“…Among our patients MEC developed in 20% of ears with retraction pockets so the rate of progression was higher. It is similar to the observation of Cassano et al [19] among untreated children with retraction pockets (20%), but in our children treatment with ventilating tubes for SOM was performed. It seems that the probability of development of MEC in CLE from preexisting retraction pocket is higher in children with cholesteatoma in the other ear.…”

Transmeatal excision of pars tensa retraction pockets with simultaneous ventilation tube insertion in children: a prospective study

“…The usual treatment modalities include watchful waiting, nasal decongestants, forced middle ear insufflation, VT insertion with or without excision of the rectracted area, laser myringoplasty, tympanoplasty with or without reinforcement of the TM and cortical mastoidectomy [4,9,10,[15][16][17][18][19]. A VT may temporarily successfully substitute the function of the ET until it falls out.…”

Ventilation tubes and indications

“…Retraksiyon olan kulaklarda iletim tipi işitme kaybı, inkus uzun kolunda erozyon, debrislerin birikerek otore hatta kolesteatom görülebilir. Labirent fistülleri ve sensorinöral işitme kaybına da nadiren neden olabilir (25,26). Pars tensa retraksiyon ceplerinin tedavisinde ortak bir görüş birliği yoktur.…”

“…Sade, retraksiyonları şu şekilde sınıflamıştır (27) Grade I retraksiyonlarda orta kulakta efüzyon varlığında VT tatbiki önerilirken, efüzyon olmadığı durumlarda hasta takip edilebilir. Grade II ve III retraksiyonlarda retraksiyon poşunun eksizyonu ve VT tatbiki, timpanoplastiye göre daha avantajlı gibi görünürken, grade IV retraksiyonlarda kartilaj timpanoplasti daha etkilidir (25)(26)(27).…”