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Eustachian tube patency and function in tympanoplasty with cartilage palisades or fascia after cholesteatoma surgery.
Otol Neurotol. 2004 Nov; 25(6):864-72.ON

Abstract

OBJECTIVE

To compare the Eustachian tube patency and function after tympanoplasty with either cartilage palisades or fascia grafting after one-stage surgery in children with tensa cholesteatoma.

STUDY DESIGN

In children operated for tensa cholesteatoma, cartilage palisade tympanoplasty was performed in 32 ears and fascia tympanoplasty in 29 ears. The patency of the Eustachian tube was evaluated by the Valsalva maneuver before the operation, 1 to 3 months after the operation, and at a follow-up examination 46(1/2) months later (median). Eustachian tube function was evaluated by the nine-step inflation/deflation tympanometric test and the Toynbee test at the follow-up examination. Otomicroscopy and hearing evaluation were performed before and after surgery as well as at the follow-up.

MAIN OUTCOME MEASURES

Eustachian tube patency and function. Hearing, postoperative eardrum perforation/retraction, and cholesteatoma recurrence.

RESULTS

The Valsalva maneuver was positive in 30% of the ears before the operation, in 65% primarily after the operation, and in 78% at the follow-up examination. A poor tubal function was found in 57% at follow-up. Overall, the late functional hearing results were better in ears with a positive Valsalva maneuver. There were no differences in tubal patency or function in relation to graft material, cholesteatoma, and tympanoplasty type. In ears with a poor tubal function, the hearing results were significantly better in the palisade group (63% success), compared with the fascia group (17% success). All of the four perforations, most of the retractions, and a single moist eardrum were found in the fascia group at the reevaluation. We found no correlation between the condition of the eardrum and the Eustachian tube function at the last evaluation. However, in ears with a poor tubal function, a nonretracted, nonperforated drum was found with higher frequency in the palisade group. Decision matrix analysis showed that the last postoperative Valsalva maneuver was the best predictor of the drum condition at the reevaluation.

CONCLUSIONS

The Eustachian tube patency frequently improves after tympanoplasty after cholesteatoma surgery in children, regardless of graft material. The patency and function of the Eustachian tube seem to be without relation to graft material, cholesteatoma, or tympanoplasty type. Cartilage palisade tympanoplasty may be a better reconstruction technique after cholesteatoma surgery, especially in ears with a poor tubal function.

Authors+Show Affiliations

Department of Otolaryngology, Gentofte University Hospital of Copenhagen, Denmark. cemuzun@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15547413

Citation

Uzun, Cem, et al. "Eustachian Tube Patency and Function in Tympanoplasty With Cartilage Palisades or Fascia After Cholesteatoma Surgery." Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, vol. 25, no. 6, 2004, pp. 864-72.
Uzun C, Cayé-Thomasen P, Andersen J, et al. Eustachian tube patency and function in tympanoplasty with cartilage palisades or fascia after cholesteatoma surgery. Otol Neurotol. 2004;25(6):864-72.
Uzun, C., Cayé-Thomasen, P., Andersen, J., & Tos, M. (2004). Eustachian tube patency and function in tympanoplasty with cartilage palisades or fascia after cholesteatoma surgery. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 25(6), 864-72.
Uzun C, et al. Eustachian Tube Patency and Function in Tympanoplasty With Cartilage Palisades or Fascia After Cholesteatoma Surgery. Otol Neurotol. 2004;25(6):864-72. PubMed PMID: 15547413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eustachian tube patency and function in tympanoplasty with cartilage palisades or fascia after cholesteatoma surgery. AU - Uzun,Cem, AU - Cayé-Thomasen,Per, AU - Andersen,Janne, AU - Tos,Mirko, PY - 2004/11/18/pubmed PY - 2005/7/1/medline PY - 2004/11/18/entrez SP - 864 EP - 72 JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology JO - Otol Neurotol VL - 25 IS - 6 N2 - OBJECTIVE: To compare the Eustachian tube patency and function after tympanoplasty with either cartilage palisades or fascia grafting after one-stage surgery in children with tensa cholesteatoma. STUDY DESIGN: In children operated for tensa cholesteatoma, cartilage palisade tympanoplasty was performed in 32 ears and fascia tympanoplasty in 29 ears. The patency of the Eustachian tube was evaluated by the Valsalva maneuver before the operation, 1 to 3 months after the operation, and at a follow-up examination 46(1/2) months later (median). Eustachian tube function was evaluated by the nine-step inflation/deflation tympanometric test and the Toynbee test at the follow-up examination. Otomicroscopy and hearing evaluation were performed before and after surgery as well as at the follow-up. MAIN OUTCOME MEASURES: Eustachian tube patency and function. Hearing, postoperative eardrum perforation/retraction, and cholesteatoma recurrence. RESULTS: The Valsalva maneuver was positive in 30% of the ears before the operation, in 65% primarily after the operation, and in 78% at the follow-up examination. A poor tubal function was found in 57% at follow-up. Overall, the late functional hearing results were better in ears with a positive Valsalva maneuver. There were no differences in tubal patency or function in relation to graft material, cholesteatoma, and tympanoplasty type. In ears with a poor tubal function, the hearing results were significantly better in the palisade group (63% success), compared with the fascia group (17% success). All of the four perforations, most of the retractions, and a single moist eardrum were found in the fascia group at the reevaluation. We found no correlation between the condition of the eardrum and the Eustachian tube function at the last evaluation. However, in ears with a poor tubal function, a nonretracted, nonperforated drum was found with higher frequency in the palisade group. Decision matrix analysis showed that the last postoperative Valsalva maneuver was the best predictor of the drum condition at the reevaluation. CONCLUSIONS: The Eustachian tube patency frequently improves after tympanoplasty after cholesteatoma surgery in children, regardless of graft material. The patency and function of the Eustachian tube seem to be without relation to graft material, cholesteatoma, or tympanoplasty type. Cartilage palisade tympanoplasty may be a better reconstruction technique after cholesteatoma surgery, especially in ears with a poor tubal function. SN - 1531-7129 UR - https://www.unboundmedicine.com/medline/citation/15547413/Eustachian_tube_patency_and_function_in_tympanoplasty_with_cartilage_palisades_or_fascia_after_cholesteatoma_surgery_ DB - PRIME DP - Unbound Medicine ER -