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Endoscopic Management of Tympanic Membrane Retraction Pockets: A Two Handed Technique with Endoscope Holder

  • Sapna Ramkrishna ParabEmail author
  • Mubarak M. Khan
Original Article
  • 16 Downloads

Abstract

The tympanic membrane retraction pocket is a pathological invagination of tympanic membrane into the middle ear space. The most common sites for formation of retraction pocket are pars flaccida and postero-superior parts. Decision about the procedure and the timing of the treatment of retraction pockets is debatable and depends on the functional and anatomic condition of the ear. To evaluate the results of the technique of two handed endoscopic management of retraction pockets with sliced tragal cartilage. Prospective Non Randomized Clinical Study. The study included 41 ears operated with the technique of two handed endoscopic cartilage tympanoplasty for retraction pockets with endoscope holders from November 2013 to May 2016 with a follow up period ranging from 22 to 53 months. Cases of cholesteatoma and tympanic membrane perforation were excluded from the study. Pre and postoperative symptoms and air–bone gaps were recorded. The average preoperative air–bone gap in the study group was 24.53 ± 4.326 dB. 28 ears were of pars tensa retractions (stage II-4, stage III-15, and stage IV-9) and 13 were pars flaccida retractions (stage III-8 and stage IV-5). 24 ears had ossicular erosion. The follow up revealed that, the results of two handed endoscopic sliced cartilage tympanoplasty for retraction pockets were stable and there was no recurrence of the retraction and the post-operative air–bone–gap closure was achieved to 13.62 ± 4.78, 14.13 ± 5.91 dB, 14.32 ± 3.46 and 14.57 ± 3.88 dB at 6 months, 1 year, 2 years, 3 years respectively. Though, indications for surgery are based mostly on anatomic status and observation of behaviour of retraction pocket over time, we recommend early management of retraction pockets by the technique of endoscopic sliced tragal cartilage tympanoplasty with tragal cartilage of 0.5 mm thickness using endoscope holder.

Level of Evidence: Level 4.

Keywords

Retraction pockets Two handed endoscopic ear surgery Endoscope holders Endoscopic sliced cartilage tympanoplasty 

Notes

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinski declaration and its later ammendments or comparable ethical standards.

Conflict of interest

None.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

12070_2019_1682_MOESM1_ESM.mkv (40.8 mb)
Supplementary material 1 (MKV 41817 kb)
12070_2019_1682_MOESM2_ESM.mkv (50.7 mb)
Supplementary material 2 (MKV 51917 kb)

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Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  1. 1.Sushrut ENT Hospital and Dr. Khan’s Research CentreTalegaon DabhadeIndia

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