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  • Title: Eustachian tube dysfunction in the pathogenesis of cholesteatoma: clinical considerations.
    Author: Chao WY, Tseng HZ, Chang SJ.
    Journal: J Otolaryngol; 1996 Oct; 25(5):334-8. PubMed ID: 8902694.
    Abstract:
    OBJECTIVE: This study was conducted to gain insight into the surgical management of cholesteatomas to prevent postoperative retraction of the tympanic membrane. DESIGN: A retrospective chart review of patients presenting between July 1988 and July 1992 was conducted. METHOD: Clinical observations were made on 85 ears from 81 patients who had tympanoplasty with mastoidectomy for middle ear cholesteatoma, with ossicular reconstruction if necessary, with a subsequent follow-up period of 36 to 84 months (mean, 60 +/- 13 months). RESULTS: The tympanic membrane in several cases became gradually retracted postoperatively; retraction generally commenced along the margin of the cartilage used for repairing the scutum defect, and was noted as early as 9 months, and after 5 years' follow-up, in as much as 66% in the 44 ears operated. CONCLUSIONS: Eustachian tube dysfunction was common postoperatively in cholesteatomatous ears; however, whether it was the etiology or the sequela of a cholesteatoma could not be deduced. Since a retraction pocket in the tympanic membrane can develop into a cholesteatoma, it may account for some cases with recurrence of cholesteatoma postoperatively. Therefore, the cartilage/perichondrium composite graft for repairing the bone defect should be as large as possible.
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