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Management of attic retraction pockets

Published online by Cambridge University Press:  19 May 2023

Vijayendra Honnurappa ,
Nilesh Mahajan Open the ORCID record for Nilesh Mahajan [Opens in a new window] ,
Vinay Kumar Vijayendra ,
Sofia Vassiliu Open the ORCID record for Sofia Vassiliu [Opens in a new window]  and
Miriam Redleaf
Vijayendra Honnurappa
Affiliation:
Vijaya ENT Care Centre, Super Speciality Otology Centre, Bangalore, India
Nilesh Mahajan*
Affiliation:
Vijaya ENT Care Centre, Super Speciality Otology Centre, Bangalore, India
Vinay Kumar Vijayendra
Affiliation:
Vijaya ENT Care Centre, Super Speciality Otology Centre, Bangalore, India
Sofia Vassiliu
Affiliation:
School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Miriam Redleaf
Affiliation:
Otology/Neurotology, Department of Otolaryngology, University of Illinois Hospitals, Chicago, USA
*
Corresponding author: Nilesh Mahajan; Email: nilesh.virtual@gmail.com
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Abstract

Objective

Attic retraction pockets, classified by degree of invasion and erosion, are reconstructed here as outlined by attic retraction pocket grade.

Method

Attic retraction pocket grade, surgical management, subsequent conditions of tympanic membrane and middle ear, and improvement of air–bone gap pure tone average were recorded.

Results

Our management strategy, based on attic retraction pocket grade, was applied to 200 ears: 44 grade I ears had non-surgical management and 156 grade II–V ears had surgical management. All 200 ears were followed up for 36–240 months, showing only 1 attic retraction pocket reformation and 1 adhesive otitis media (complication rate of 1 per cent), and improved air–bone gaps (p < 0.05). An earlier series of 50 grade IV attic retraction pockets used atticotomy with epitympanic reconstruction. These showed attic retraction pocket recurrence or cholesteatoma onset in 34 ears (68 per cent). When these ears were revised per protocol, there was no evidence of cholesteatoma thereafter.

Conclusion

Reconstruction of the ossicles and scutal defect according to attic retraction pocket grade shows long-term stability of the tympanic membrane, middle ear and hearing.

Keywords

Cartilageear ossiclescholesteatomahearing
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 11 , November 2023 , pp. 1272 - 1276
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Nilesh Mahajan takes responsibility for the integrity of the content of the paper

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