Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-25T13:30:32.729Z Has data issue: false hasContentIssue false

Management of retraction pockets of the pars tensa in children by excision and ventilation tube insertion

Published online by Cambridge University Press:  29 June 2007

R. M. Walsh*
Affiliation:
Department of Otolaryngology, Lewisham Hospital, London SE13 n6LH, UK.
J. P. Pracy
Affiliation:
Department of Otolaryngology, Lewisham Hospital, London SE13 n6LH, UK.
L. Harding
Affiliation:
Department of Otolaryngology, Lewisham Hospital, London SE13 n6LH, UK.
D. A. Bowdler
Affiliation:
Department of Otolaryngology, Lewisham Hospital, London SE13 n6LH, UK.
*
Mr R. M. Walsh, Department of Otolaryngology, Lewisham Hospital, Lewisham High Street, London SE13 6LH

Abstract

Retraction pockets of the pars tensa in children can result in erosion of the ossicles leading to hearing loss and eventually cholesteatoma formation. Several different types of treatment for the more severe grades of retraction pocket have been described. The aim of this pilot study was to assess the outcome following simple excision and ventiolation tube insertion of grade II, III and IV retraction pockets of the pars tensa. The eardrums were grades according to Sadé's classification (1979).

There were seven grade II and four garade III ratractions. Ten eardrums healed completely in a mean time of 3.6 months (mean follow-up 16 months) and there was one residual perforation. Two retractions recurred and both of these were only grade I. Clinically, an improvement in hearing was reported in seven children (eight ears) and the average air conduction threshold gain for these patients was 16 dB. A larger prospective study is currently underway.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

eferences

Arving, J. (1963) Some problems concerning the prognosis and treatment of chronic adhesive otitis media and of serous otitis media. Acta Otolaryngologica 188 (suppl.): 7576.Google Scholar
Bennet, R. G. (1970) The significance and management of the drumhead retraction pocket. Journal of Laryngology and Otology 84: 167189.Google Scholar
Charachon, R., Barthez, M., Lejeune, J. M. (1992) Spontaneous retraction pockets in chronic otitis media: medical and surgical therapy. Ear, Nose and Throat Journal 71(11): 578583.Google Scholar
Chole, R., Kodama, K. (1989) Comparative histology of the tympanic membrane and its relationship to cholesteatoma. Annals of Otology, Rhinology and Laryngology 98: 761766.CrossRefGoogle ScholarPubMed
Glasscock, M., Jackson, C. G., Schwaber, M. K. (1987) Chronic ear disease: surgical decisions and techniques. American Academy of Otolaryngdlogy–Head and Neck Surgery Instructional Course 1338.Google Scholar
Grahn, B. (1964) Simple mastoidectomy with air chamber creation in progressive adhesive otitis. Acta Otolaryngogica 58: 258270.Google Scholar
Levinson, R. M. (1987) Cartilage-perichondrial composite graft tympanoplasty in the treatment of posterior marginal and attic retraction pockets. Laryngoscope 97: 10691074.Google Scholar
Mills, R. P. (1991) Management of retraction pockets of the pars tensa. Journal of Laryngology and Otology 105: 525528.CrossRefGoogle ScholarPubMed
Palva, T. (1963) Surgical management of chronic adhesive otitis media. Acta Otolaryngologica 188: 7074.Google Scholar
Roulleau, P. (1988) Fixed retraction pockets and their treatment. Revue de Largyngologie, Otologie et Rhinologie (Bordeaux) 109: 209211.Google Scholar
Sadé, J. (1987) Treatment of cholesteatoma. American Journal of Otolaryngology 8: 524533.Google Scholar
Sadé, J. (1979) The atelectatic ear. In Monograms in Clinical Otolaryngology. Vol. 1: Secretory otitis media and its sequelae. Churchill-Livingstone, New York, Edinburgh and London, pp 6488.Google Scholar
Sharp, J. F., Robinson, J. M. (1992) Treatment of tympanic membrane retraction pockets by excision: a prospective study. Journal of Laryngology and Otology 106: 882886.Google Scholar
Sirala, U. (1963) Pathogenesis and treatment of adhesive otitis. Acta Otolaryngologica 188 (suppl.): 918.Google Scholar
Tos, M. (1992) Can cholesteatoma be prevented? In Proceedings of the Second International Coference on Chlesteatoma and Mastoid Surgery.Tel Aviv Kugler Publications. Amsterdam, pp 591597.Google Scholar
Wells, M. D., Michaels, L. (1983) Role of retraction pockets in cholesteatoma formation. Clinical Otolaryngology 8: 3945.Google Scholar
Wells, M. D., Michaels, L. (1991) Mode of growth of acquired cholesteatoma. Journal of Laryngology and Otology 105: 261267.Google Scholar
Yoon, T. H., Schachen, P. A., Paparella, M. M., Aeppli, D. M. (1990) Pathology and pathogenesis of tympanic membrane retraction. American Journal of Otolaryngology 11: 1017.Google Scholar