Michele Cassano1, Pasquale Cassano. 1. Department of Otorhinolaryngology, University of Foggia, Via Guerrieri 2, 71100 Foggia, Italy. m.cassano@unifg.it
Abstract
OBJECTIVE: To assess outcome in pediatric patients after treatment for retraction pockets of pars tensa in relation to retraction grade, site, occurrence of complications, and patient age. METHODS: Outcomes in 45 ears of 37 children medically or surgically treated for retraction pockets were compared to a control group of 40 untreated children over a follow-up period of at least 24 months. Grade I and II retractions were treated with medical therapy or ventilation tube insertion; in III or IV grade retractions, excision and tympanic reinforcement with cartilage grafting and in some cases ossiculoplasty were performed. RESULTS: Medical treatment or ventilation tube insertion resolved grade I and II retractions in 94% of cases. In grade III or IV retractions the anatomic success rate was 75.8%. Normal hearing (air-bone gap <10 dB) was restored in 31 (68.8%) cases. Surgical failures and complications (recurrence, tympanic membrane perforation, progression to cholesteatoma) were higher in posterior retractions. In the control group, only 35% of retractions healed spontaneously; in the remaining cases the condition progressed to more serious retractions or complications. CONCLUSION: A wait and see approach or conservative therapy is indicated only in mild-to-moderate retraction pockets owing to their benign prognosis. Pocket excision and tympanic reinforcement are absolutely indicated in advanced retractions with complications and/or bilateral conductive hearing loss to avert progression to more serious pathologies. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
OBJECTIVE: To assess outcome in pediatric patients after treatment for retraction pockets of pars tensa in relation to retraction grade, site, occurrence of complications, and patient age. METHODS: Outcomes in 45 ears of 37 children medically or surgically treated for retraction pockets were compared to a control group of 40 untreated children over a follow-up period of at least 24 months. Grade I and II retractions were treated with medical therapy or ventilation tube insertion; in III or IV grade retractions, excision and tympanic reinforcement with cartilage grafting and in some cases ossiculoplasty were performed. RESULTS: Medical treatment or ventilation tube insertion resolved grade I and II retractions in 94% of cases. In grade III or IV retractions the anatomic success rate was 75.8%. Normal hearing (air-bone gap <10 dB) was restored in 31 (68.8%) cases. Surgical failures and complications (recurrence, tympanic membrane perforation, progression to cholesteatoma) were higher in posterior retractions. In the control group, only 35% of retractions healed spontaneously; in the remaining cases the condition progressed to more serious retractions or complications. CONCLUSION: A wait and see approach or conservative therapy is indicated only in mild-to-moderate retraction pockets owing to their benign prognosis. Pocket excision and tympanic reinforcement are absolutely indicated in advanced retractions with complications and/or bilateral conductive hearing loss to avert progression to more serious pathologies. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Authors: Yi Shen; Sharon Leanne Redmond; Bing Mei Teh; Sheng Yan; Yan Wang; Lin Zhou; Charley A Budgeon; Robert Henry Eikelboom; Marcus David Atlas; Rodney James Dilley; Minghao Zheng; Robert Jeffery Marano Journal: Tissue Eng Part A Date: 2012-12-10 Impact factor: 3.845
Authors: Ahmed B Bayoumy; Christianne C A F M Veugen; Erwin L van der Veen; Jan-Willem M Bok; Jacob A de Ru; Hans G X M Thomeer Journal: Eur Arch Otorhinolaryngol Date: 2021-03-10 Impact factor: 2.503