title: Differences in middle ear ventilation disorders between pars flaccida and pars tensa cholesteatoma in sonotubometry and patterns of tympanic and mastoid pneumatization.
abstract: OBJECTIVE
  To investigate differences in middle ear ventilation mechanisms between pars flaccida and pars tensa cholesteatoma.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  A referral hospital otolaryngology department.
  
  
  METHODS
  Sixty-six ears with pars flaccida cholesteatoma (mean age, 45.7 yr) and 19 ears with pars tensa cholesteatoma (mean age, 58.8 yr) were included. Patients with totally adhesive tympanic membranes or mixed-type cholesteatoma were excluded.
  
  
  METHODS
  Patients underwent canal wall down tympanoplasty with canal reconstruction. The canal wall was reconstructed with tragal or conchal cartilage and cortical bone grafts.
  
  
  METHODS
  Habitual sniffing, preoperative sonotubometry results, mastoid pneumatization (maturation), and postoperative aeration around the stapes were investigated. Preoperative mastoid pneumatization and postoperative aeration around the stapes were measured on computed tomography scans.
  
  
  RESULTS
  Ten (15.4%) of 65 patients with pars flaccida cholesteatoma and 3 (15.7%) of 19 patients with pars tensa cholesteatoma were habitual sniffers (p = 0.5). Preoperative sonotubometry indicated that a patulous pattern was more common in ears with pars flaccida than pars tensa cholesteatoma (42.8% versus 7.1%, p < 0.05), and a stenotic pattern was more common in ears with pars tensa than pars flaccida cholesteatoma (85.8% versus 42.8%, p < 0.01). Preoperative mastoid pneumatization and postoperative aeration around the stapes were significantly better in ears with pars flaccida than pars tensa cholesteatoma (p < 0.01 and p < 0.05, respectively).
  
  
  CONCLUSIONS
  Significantly different tubal function and mastoid pneumatization patterns suggest differences in ventilation disorders and cause between ears with pars flaccida and pars tensa cholesteatoma.
authors.affiliation: Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama, Japan. aknewpan@jichi.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shinnabe
authors.forename: Mariko
authors.initials: M
authors.lastname: Hara
authors.forename: Masayo
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Shingo
authors.initials: S
authors.lastname: Matsuzawa
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kanazawa
authors.forename: Takeharu
authors.initials: T
authors.lastname: Kanazawa
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yoshida
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Iino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018424:Cholesteatoma, Middle Ear / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008876:Middle Ear Ventilation; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000503:physiopathology / Q000601:surgery*; D014433:Tympanoplasty / Q000379:methods*