Histological analysis of retraction pocket pars tensa of tympanic membrane in children

Urík, Milan; Hurník, Pavel; Žiak, Dušan; Macháč, Josef; Šlapák, Ivo; Motyka, Oldřich; Vaculová, Jana; Jana, Debarshi

doi:10.1016/j.ijporl.2016.05.007

Cited by 6 publications

(7 citation statements)

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“…We identified the pathological anomalies in the structure of external and middle layers of the tympanic membrane compared with normal healthy tympanic membrane. We identified subepithelial inflammation infiltrate in 86% of patients, disruption of a double layer of collagen fibers and its infiltration by neutral mucosubstances in 87% and fragmented elastic fibers in 96% ( Figure 2 ) [ 31 ]. Degeneration of the middle collagenous fibrous layer caused by inflammation was observed by Sade [ 1 ] or Yoon [ 32 ].…”

Section: The Role Of Inflammation In Pathogenesis Of the Retraction Pocketmentioning

confidence: 99%

“…Degeneration of the middle collagenous fibrous layer caused by inflammation was observed by Sade [ 1 ] or Yoon [ 32 ]. We also described hyperkeratosis (100%) and ingrowing rete pegs (71%) [ 31 ]. In the outer layer of the tympanic membrane (epidermis), we identified a presence of Ki67 in the cells of both basal and suprabasal layers.…”

Section: The Role Of Inflammation In Pathogenesis Of the Retraction Pocketmentioning

confidence: 99%

“…These observations suggest an increase of proliferation activity in squamous epithelia. The process of keratinocyte proliferation within cholesteatoma epithelium is important not only for understanding the complex mechanisms of the pathogenesis of this disease, but also to anticipate the possible development or recurrence of cholesteatoma [ 30 , 31 , 32 , 33 ]. We identified CD45 LCA positivity, which is typical for all categories of white blood cells, in both the tympanic membrane’s external epithelial layer and its central connective tissue layer ( Figure 3 ).…”

Section: The Role Of Inflammation In Pathogenesis Of the Retraction Pocketmentioning

confidence: 99%

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Pathogenesis of Retraction Pocket of the Tympanic Membrane—A Narrative Review

2021

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Several theories describe the development of the retraction pocket of the tympanic membrane (RP). Many authors suggest that the negative middle ear pressure is the main reason responsible for developing this condition. A narrative review has been undertaken, and conclusions are drawn reflecting a current knowledge with our new observations in the histological and immunohistochemical study. Recent studies show the important role of inflammation in the development and progression of RP. A review of the available literature shows that the inflammation plays a key role in pathogenesis of the RP and its progression to the cholesteatoma. We support this statement with our new results from histological and immunohistochemical analysis of the RPs.

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Section: The Role Of Inflammation In Pathogenesis Of the Retraction Pocketmentioning

confidence: 99%

Section: The Role Of Inflammation In Pathogenesis Of the Retraction Pocketmentioning

confidence: 99%

Section: The Role Of Inflammation In Pathogenesis Of the Retraction Pocketmentioning

confidence: 99%

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Pathogenesis of Retraction Pocket of the Tympanic Membrane—A Narrative Review

2021

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“…Long-term retraction pockets eventually lead to ossicular erosion, hearing loss and may further progress to cholesteatoma formation. 1 2 …”

Section: Introduction and Objectivesmentioning

confidence: 99%

“…Long-term retraction pockets eventually lead to ossicular erosion, hearing loss and may further progress to cholesteatoma formation. 1,2 To prevent the complications related to retraction, early intervention is often necessary. The options available to the clinician are many, ranging from wait and watch, medical treatment, and surgical intervention.…”

Section: Introduction and Objectivesmentioning

confidence: 99%

Evaluation of Recurrence and Hearing Outcome for Inactive Squamosal Disease after Cartilage Strengthening Tympanoplasty

Gupta

Rawat

Aseri

et al. 2022

Int Arch Otorhinolaryngol

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Introduction Inactive squamosal disease is unique for having a conflicting treatment protocol, with an age-old debate between early surgical intervention or keeping patients in a long-term follow-up. The shifting paradigm is early intervention to prevent further progress into active disease and improve hearing outcome in its nascent stage. Objective To evaluate recurrence and hearing outcome in cases of inactive squamosal disease after cartilage strengthening tympanoplasty. Methods The study was conducted on 50 patients with inactive squamosal disease. Detailed examination was done to grade the retraction. All patients underwent autologous conchal cartilage tympanomastoidectomy with temporalis fascia grafting. Recurrence and hearing evaluations were done by pure tone audiogram at regular intervals for one year. Results Hearing loss was the most common presenting symptom. Isolated pars tensa retractions were more common (54%) than pars flaccida (12%), or those involving both (34%). Ossicular status was normal in only 14% of the cases, and the most common ossicular damage was to the lenticular process of the incus (52%). Three of the patients (6%) had residual perforation at the 3rd month of follow-up. Subjective improvement in hearing was reported by 42% patients. Hearing improvement greater than 10 dB was found in 24 patients (48%). Air–bone gap reduced from 25.16 ± 8.15 dB preoperatively to 12.90 ± 6.20 at 1 year of follow-up. Recurrence was seen in three patients (6%). Conclusion Early intervention by cartilage strengthening of weakened tympanic membrane and ossicular reconstruction not only offers better hearing results, but also prevents progress to active disease.

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