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  Patronage of the Polish Society of Audiology and Phoniatrics

vol 13. no 2. June 2014  

 Original articles
Retraction pockets of tympanic membrane: protocol of management and results of treatment
Józef Mierzwiński, Andrew J. Fishman

Introduction. Decisions on the procedure to be used in the
treatment of retraction pockets (RP) depends on the functional
and anatomic condition of the ear, but still continue to be
debatable. The authors propose the protocol of the procedure
to be applied for the management of RP and present the analysis
of the accordingly implemented treatment.
Aim. To find the most appropriate way of management of
atelectatic changes of tympanic membrane TM and analyse
the results of the proposed procedure.
Materials and methods. Fifty nine ears of 53 patients had been
followed up since 2002 till 2008. Forty nine children and 4 adults
5-36 years of age (mean 10.6) were included into the study. RP
excision was performed in 8 ears, cartilage tympanoplasty in 25
ears and T-tube insertion in 26 ears.
Results. Primarily, in short term observations, good results were
obtained in 88% of patients after cartilage tympanoplasty, 79%
after T-tube insertion and 76% after excision of RP. However,
further follow up revealed that, in a substantial number of T‑tube
patients the disorder tended to recur and required further
interventions. The results after cartilage tympanoplasty were
most stable.
Conclusions. Early use of cartilage as tympanic membrane
reinforcement is indicated both in Charachon type 2 and type
3 pockets. Indications for surgery should be based mostly on
anatomic status and observation of behavior of retraction pocket
over time, since hearing in that disorder usually continues to be
normal for a long period of time.

keywords: leczenie, kieszonki retrakcyjne, ucho atelektatyczne, tympanoplastyka prewencyjna, perlak,tympanoplastyka z chrząstką, treatment, retraction pocket, atelectatic ear, preventive tympanoplasty, cholesteatoma, cartilage tympanoplasty

pages: from 114 to 121

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