Eustachian tube dysfunction in the pathogenesis of cholesteatoma: clinical considerations.
OBJECTIVE
This study was conducted to gain insight into the surgical management of cholesteatomas to prevent postoperative retraction of the tympanic membrane.


METHODS
A retrospective chart review of patients presenting between July 1988 and July 1992 was conducted.


METHODS
Clinical observations were made on 85 ears from 81 patients who had tympanoplasty with mastoidectomy for middle ear cholesteatoma, with ossicular reconstruction if necessary, with a subsequent follow-up period of 36 to 84 months (mean, 60 +/- 13 months).


RESULTS
The tympanic membrane in several cases became gradually retracted postoperatively; retraction generally commenced along the margin of the cartilage used for repairing the scutum defect, and was noted as early as 9 months, and after 5 years' follow-up, in as much as 66% in the 44 ears operated.


CONCLUSIONS
Eustachian tube dysfunction was common postoperatively in cholesteatomatous ears; however, whether it was the etiology or the sequela of a cholesteatoma could not be deduced. Since a retraction pocket in the tympanic membrane can develop into a cholesteatoma, it may account for some cases with recurrence of cholesteatoma postoperatively. Therefore, the cartilage/perichondrium composite graft for repairing the bone defect should be as large as possible.
Chao
W Y
WY
Department of Otolaryngology, National Cheng Kung University, College of Medicine, Tainan, Taiwan.
Tseng
H Z
HZ
Chang
S J
SJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000145:classification / Q000209:etiology* / Q000601:surgery*; D005064:Eustachian Tube / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014432:Tympanic Membrane / Q000473:pathology / Q000601:surgery; D014433:Tympanoplasty / Q000009:adverse effects