Pars Tensa Retractions Without Cholesteatoma in Children

Jesić, S; Rovcanin, Lejla Hilmo; Jovicevic, Ognjen Djordjije; Jotić, Ana; Slijepčević, Nikola; Ljubic, Vladimir Radoslav

doi:10.1097/mao.0000000000000316

Cited by 8 publications

(8 citation statements)

References 13 publications

(18 reference statements)

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“…However, the ABG's PTA was not a predictor of ossicular chain erosion. This corroborates with the existing data, which shows no correlation between hearing thresholds and the stages of retraction (11,14).…”

Section: Discussionsupporting

confidence: 93%

“…In the present study, we analyzed the behavior of retractions in all areas of TM, and we observed that the majority of retractions (64%) had an association with affected regions. Jesic et al (14) showed that the combination of PF and PT retractions in the same ear was a predictor of a long incus process and stapes superstructure erosion. However, the ABG's PTA was not a predictor of ossicular chain erosion.…”

Section: Discussionmentioning

confidence: 99%

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Audiometric Pattern in Moderate and Severe Tympanic Membrane Retraction

Canali

Rosito

Longo

et al. 2021

Otology &Amp; Neurotology

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Objective:To evaluate the audiometric pattern in moderate/severe retractions of the tympanic membrane and correlate it with the severity of the otoscopy findings.Study Design:Cross-sectional study.Setting:Tertiary hospital.Patients:Consecutive patients with moderate or severe tympanic membrane retraction in at least one ear (451 ears) between August 2000 and January 2019, and no surgical history or effusion (mean [standard deviation] age, 32.8 [20.2] yr; 54% female and 42.4% children).Intervention:Pure-tone audiometry.Main Outcome Measures:Air conduction (AC) and bone conduction thresholds, and air-bone gap (ABG) measured at the four-frequency pure-tone average.Results:The median in decibel hearing level (dB HL) (minimum–maximum) of the AC, BC, and ABG were 25 dB HL (0–120 dB HL), 10 dB HL (0–75 dB HL), and 12.5 dB HL (0–55 dB HL), respectively. Seventy-two percent of the ears had an ABG ≤ 20 dB HL. For severity of the retraction of pars flaccida (PF), the AC, bone conduction, and ABG were similar across groups, with a weak correlation. For the pars tensa (PT), there was a global difference in the medians of AC and ABG in terms of the degree of severity, with a moderate correlation. Retraction in PF and PT at the same time was observed in 6 4% of the ears. ABG median was lower in ears with PF retraction (6.25 dB HL) than PT retraction, isolated (15 dB HL) or not (13.75 dB HL; p < 0.05).Conclusion:The ABG pure-tone average median was higher when PT was involved. We found a significant correlation between the retraction severity and worsening of AC and ABG thresholds, only for PT.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Audiometric Pattern in Moderate and Severe Tympanic Membrane Retraction

Canali

Rosito

Longo

et al. 2021

Otology &Amp; Neurotology

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Section: Resultsmentioning

confidence: 99%

“…One study 16 aimed to improve middle ear ventilation via ventilation tube insertion. As part of a prospective study 16 10 ears with combined tensa (Sade grades I–II) and flaccida (Tos grades I–IV) retractions underwent aeration tube insertion. The authors report that out of the group of 10 ears (Sade grades I–II) with aeration tube insertion, seven had post‐operative retractions.…”

Section: Resultsmentioning

confidence: 99%

A narrative review of the management of pars flaccida tympanic membrane retractions without cholesteatoma

Bateman

Borsetto

Boscolo‐Rizzo

et al. 2023

Clinical Otolaryngology

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ObjectiveReview the effectiveness of surgical and non‐surgical management strategies for isolated pars flaccida and combined pars tensa and flaccida tympanic membrane retractions in preventing progression or recurrence, improving hearing and preventing development of cholesteatoma.DesignNarrative review.SettingENT and otology services worldwide.ParticipantsPatients with non‐cholesteatoma tympanic membrane retractions.Main Ouctome measureChanges in retraction (progression or resolution, or development of a known sequela such as perforation).ResultsEight full text papers are included: three randomised controlled trials and five case series or cohort studies of more than five patients (a total of 238 ears). Data exists for the use of conservative management, ventilation tubes, laser tympanoplasty, cartilage and fascia tympanoplasty, lateral attic reconstruction as well as mastoid procedures.ConclusionFew high‐quality studies on the management of isolated and combined pars flaccida retractions exist. For isolated pars flaccida retractions deemed to require surgical intervention, this review suggests that lateral attic reconstruction and cartilage tympanoplasty carries least risk of recurrence.

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“…A normal tympanic membrane is tough and elastic, but the retraction pocket is flexible and collapses into the tympanic cavity. The place of weakness is most often located near the anatomical structures such as incisura Rivini, scutum or malleus [ 12 ]. It can affect both parts of the TM, pars tensa or pars flaccida.…”

Section: Introductionmentioning

confidence: 99%

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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Pars Tensa Retractions Without Cholesteatoma in Children

Cited by 8 publications

References 13 publications

Audiometric Pattern in Moderate and Severe Tympanic Membrane Retraction

Audiometric Pattern in Moderate and Severe Tympanic Membrane Retraction

A narrative review of the management of pars flaccida tympanic membrane retractions without cholesteatoma

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

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