Retraction pocket excision with cartilage grafting as a preventive surgery for cholesteatoma  

作　　者：Comacchio Francesco Mion Marta Pedruzzi Barbara 

机构地区：[1]Institute of Otolaryngology, Department of Neurosciences, Padova University, Via Giustiniani 2, 35121 Padova, Italy [2]Institute of Otolaryngology, Ospedali Riuniti Padova Sud, Via Albere 30, 35043 Monselice, Italy

出　　处：《Journal of Otology》2017年第3期112-116,共5页中华耳科学杂志（英文版）

摘　　要：Aims: The goal of the present study is to summarize our experience on surgical management of retraction pockets(RP) as a preventive tool against cholesteatomas.Methods:Twenty-five ears have been followed up for a mean period of 6.16 ± 4.35 years(from 1 to 17 years). The sample presented a mean age of 47.56 + 19.11 years(from 16 to 73 years). All patients underwent cartilage graft surgery. Furthermore 10(40%) underwent tympanoplasty(TPL) type Ⅰ, 14(56%) TPL type Ⅱ and 1(4%) TPL type Ⅴ.Results: Eleven ears(44%) showed cholesteatoma: all these cases were stage Ⅲ according to Charachon staging, and stage Ⅳ or Ⅴ according to Gersdorff classification. Twelve patients(48%) showed erosion of the ossicular chain. Of these, five were associated with cholesteatoma and seven only with retraction. The recurrence rate of cholesteatoma was 12%. None of the patients with a stage Ⅱ or Ⅲ RP(according to Gersdorff classification) developed cholesteatoma. The recurrence of RP was 0%.In regards to literature review, seven references were selected. These studies showed a success rate ranging from 79.1% to 88%, while recurrences of RP varied from 6.4% to 13%. Only one study specified a recurrence rate of cholesteatoma of 28%.Conclusions: Surgical treatment of stages Ⅱ and Ⅲ RP is an effective tool to prevent cholesteatoma formation. The presence of keratin accumulation and cholesteatoma at the RP(stages Ⅳ and Ⅴ, according to Gersdorff) are the real predictors of poor prognosis.Aims: The goal of the present study is to summarize our experience on surgical management of retraction pockets(RP) as a preventive tool against cholesteatomas.Methods:Twenty-five ears have been followed up for a mean period of 6.16 ± 4.35 years(from 1 to 17 years). The sample presented a mean age of 47.56 + 19.11 years(from 16 to 73 years). All patients underwent cartilage graft surgery. Furthermore 10(40%) underwent tympanoplasty(TPL) type Ⅰ, 14(56%) TPL type Ⅱ and 1(4%) TPL type Ⅴ.Results: Eleven ears(44%) showed cholesteatoma: all these cases were stage Ⅲ according to Charachon staging, and stage Ⅳ or Ⅴ according to Gersdorff classification. Twelve patients(48%) showed erosion of the ossicular chain. Of these, five were associated with cholesteatoma and seven only with retraction. The recurrence rate of cholesteatoma was 12%. None of the patients with a stage Ⅱ or Ⅲ RP(according to Gersdorff classification) developed cholesteatoma. The recurrence of RP was 0%.In regards to literature review, seven references were selected. These studies showed a success rate ranging from 79.1% to 88%, while recurrences of RP varied from 6.4% to 13%. Only one study specified a recurrence rate of cholesteatoma of 28%.Conclusions: Surgical treatment of stages Ⅱ and Ⅲ RP is an effective tool to prevent cholesteatoma formation. The presence of keratin accumulation and cholesteatoma at the RP(stages Ⅳ and Ⅴ, according to Gersdorff) are the real predictors of poor prognosis.

关 键 词：CARTILAGE CHOLESTEATOMA Graft Pockets RETRACTION 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]