Surgical treatment of retraction pocket with bone pate: scutum plasty for cholesteatoma.
OBJECTIVE
Postoperative attic retraction pocket is a critical issue and may be indicative of disease recurrence after canal-up tympanoplasty for middle ear cholesteatoma. Although scutum plasty is an acceptable procedure that can be used to prevent the pocket formation, how the scutum is reconstructed has remained controversial. The aim of this study was to clarify the value of scutum plasty using bone pate.


METHODS
Retrospective study.


METHODS
Bone pate scutum plasty was performed in 69 ears during first-stage operations. We attempted to reconstruct a smooth attic bony wall. At the time of the second-stage operations, the results of the scutum plasty were examined.


RESULTS
The incidence of retraction pocket was statistically reduced from 20.2% to 5.8%.


CONCLUSIONS
Although the reconstructed scutum showed atrophy to some extent, bone pate scutum plasty is effective in preventing postoperative retraction pocket if a smoothly shaped attic wall can be reconstructed.
Hinohira
Yasuyuki
Y
Department of Otolaryngology, Takanoko Hospital, Ehime, Japan. hinohira@ehime-u.ac.jp
Yanagihara
Naoaki
N
Gyo
Kiyofumi
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D018786:Bone Substitutes; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D004129:Dimethylpolysiloxanes; D004432:Ear, Middle / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000637:transplantation*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D012828:Silicones; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000009:adverse effects* / Q000379:methods*
D018786:Bone Substitutes; D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon