title: Effect of the tympanostomy tube on postoperative retraction of the soft posterior meatal wall caused by habitual sniffing.
abstract: OBJECTIVE
  To evaluate the effect of the tympanostomy tube (TT) on postoperative retraction of the soft posterior meatal wall caused by habitual sniffing following ear surgery, including a mastoidectomy and soft-wall reconstruction of the posterior meatal wall.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Sixty-six ears of 64 patients with acquired cholesteatoma who underwent staged ear surgery with a soft-wall reconstruction method and mastoidectomy were enrolled; 26 out of 66 ears had habitual sniffing (sniffing positive[+]), underwent TT placement (TT positive[+]) during surgery, and were followed up for at least 8 months after surgery. Sixty-six ears were divided into sniffing+/TT+, sniffing negative(-)/TT+, and sniffing-/TT- groups, and the degree of the retraction was compared among the three groups.
  
  
  RESULTS
  The distribution of the grades of the postoperative retraction of the soft posterior meatal wall was almost the same among the three groups (P = .60). Ears with severe retraction were found in 19.2% (5/26), 33.3% (7/21), and 15.8% (3/19) in the sniffing+/TT+ group, sniffing-/TT+ group, and sniffing-/TT- groups, respectively.
  
  
  CONCLUSIONS
  The TT was found to be effective in preventing the development of postoperative retraction of the reconstructed soft posterior meatal wall and tympanic membrane among cases with habitual sniffing. We would suggest that TT placement is recommended during surgery for cholesteatoma if a patient was found to engage in habitual sniffing.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan. tomomiyf@net.nagasaki-u.ac.jp
authors.forename: Tomomi
authors.initials: T
authors.lastname: Yamamoto-Fukuda
authors.forename: Kenji
authors.initials: K
authors.lastname: Takasaki
authors.forename: Haruo
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D018424:Cholesteatoma, Middle Ear / Q000503:physiopathology / Q000601:surgery*; D003251:Constriction, Pathologic; D004432:Ear, Middle / Q000601:surgery; D005064:Eustachian Tube / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006184:Habits; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D008876:Middle Ear Ventilation / Q000295:instrumentation*; D009666:Nose / Q000503:physiopathology; D038781:Otoscopy; D011184:Postoperative Period; D012189:Retrospective Studies; D055502:Secondary Prevention