Shall We Resect the Tip of Manubrium Mallei in Tympanoplasty?

Abstract

ObjectivesIn tympanoplasty operations if perforation is related with malleus handle, malleus handle is desepithelised. We planned this research to investigate whether the epithelial remnants remain as a result of this desepithelisation or not.MethodsThe 35 patients who were performed tympanoplasty operation were divided into two groups. In the first group which included 13 patients the tip portion of manubrium mallei were cut off without desepithelisation. In the second group which included 22 patients the tip portions of manubrium mallei were cut off after the meticulous desepithelisation. The presence of squamous epithelium was examined histopathologically on the specimens.ResultsSquamous epithelium was observed in 9 of the 13 non-desepithelised specimens and in 6 of 22 desepithelised specimens.ConclusionIn tympanoplasty operations despite careful desepithelisation, squamous epithelial remnants may remain on the malleus handle. So the tip of manubrium mallei could be resected to prevent the future development of cholesteatoma.

Diagnostic accuracy of intra-operative assessment of de-epithelisation of the malleus by the surgeon in type 1 tympanoplasty compared to histopathological examination

“…When the likelihood of residual epithelium over the umbo is significant, the surgeon can resect the umbo 6,22 and conveniently place the graft medial to the handle of the malleus. 5 In our study, 13 specimens (30.95 per cent) had residual epithelium on histopathological examination.…”