Habitual sniffing and postoperative configuration of the posterior meatal wall reconstructed with soft tissue

Abstract

The postoperative configuration of the posterior meatal wall showed severe retraction in 7 of 8 patients with habitual sniffing, but only 22 of 47 without habitual sniffing. Habitual sniffing was significantly associated with postoperative severe retraction (Fisher's exact test, p<0.05).

Relationship between tympanic membrane retraction and habitual sniffing in patients with cholesteatoma

“…Kawase et al [16] reported that the cessation of habitual sniffing is one of the primary and most important ways to prevent postoperative retraction of the tympanic membrane. In the present study, we tried to encourage patients to cease sniffing and suggested that this effect would help prevent postoperative retraction of the tympanic membrane.…”

Management of Acquired Cholesteatoma Associated With Patulous Eustachian Tube and Habitual Sniffing

“…Habitual sniffing has been claimed to be a significant contributing factor to the development of postoperative retraction of the reconstructed posterior meatal wall and tympanic membrane [2]. Kawase et al [22] reported severe retraction of the posterior meatal wall was found in seven of eight patients with habitual sniffing, but was significantly less (22 of 47) in ears without habitual sniffing. Yamamoto-Fukuda et al [23] indicated that a tympanostomy tube was found to be effective in preventing the development of postoperative retraction of the reconstructed soft posterior meatal wall and tympanic membrane among cases with habitual sniffing.…”

Effect of the tympanostomy tube on postoperative retraction of the soft posterior meatal wall caused by habitual sniffing

“…Repetitive production of high negative middle ear pressure caused by habitual sniffing could be another cause of the retraction 17. In such cases, high negative middle ear pressure and subsequent retraction of the soft posterior meatal wall should happen frequently, with little regard to the condition of the mucosa.…”

“…It seemed that such sniffing induces a high negative pressure in the middle ear and may sometimes cause cholesteatoma or its recurrence after surgery 13–16. In patients with acquired cholesteatoma who underwent the SWR method, Kawase and colleagues17 indicated a significantly frequent association of severe postoperative retraction of the soft wall with negative pressure caused by habitual sniffing, and concluded that habitual sniffing was one of the important causal factors for retraction‐type recurrent cholesteatoma.…”