PMID- 18490571
OWN - NLM
STAT- MEDLINE
DCOM- 20080605
LR  - 20080520
IS  - 1538-361X (Electronic)
IS  - 0886-4470 (Linking)
VI  - 134
IP  - 5
DP  - 2008 May
TI  - Intratympanic membrane cholesteatoma after tympanoplasty with the underlay 
      technique.
PG  - 501-2
LID - 10.1001/archotol.134.5.501 [doi]
AB  - OBJECTIVE: To evaluate the incidence of intratympanic membrane cholesteatoma 
      (ITMC) in patients after tympanoplasty with the underlay technique. DESIGN: 
      Retrospective study. SETTING: Ear, nose, and throat department, Tabriz University 
      of Medical Sciences, Tabriz, Iran. PATIENTS: A total of 1121 patients with 
      central tympanic membrane perforation were evaluated after tympanoplasty. 
      INTERVENTIONS: Tympanoplasty was performed with the underlay technique using 
      temporal facial graft. MAIN OUTCOME MEASURE: The patients were followed up to 
      assess the postoperative incidence of ITMC. RESULTS: During the follow-up period 
      of 5 years, ITMC was observed in 9 patients (0.8%). Of these 9 patients, 8 were 
      asymptomatic and had intact tympanic membranes. The asymptomatic cases were 
      detected 1 to 2 years after surgery during routine follow-up examinations. Only 1 
      of 9 patients had otorrhea, which was due to a posterior perforation away from 
      the location of the ITMC. The most common site of the ITMC was near the umbo. 
      CONCLUSIONS: Even after tympanoplasty with underlay technique, ITMC may develop 
      between the layers of the tympanic membrane. The most common location of these 
      cholesteatomas is near the umbo, which may be the result of insufficient removal 
      of the residual squamous epithelium from the handle of the malleus. The 
      cholesteatomas are usually asymptomatic and can be detected during routine 
      follow-up examinations 1 to 2 years after surgery. Although ITMCs are usually 
      noninvasive in nature, a review of the literature revealed that in rare cases 
      they can also show a rapid and invasive growth pattern. Early detection and 
      removal of these asymptomatic cholesteatomas during routine postoperative 
      follow-up examinations can prevent their progression as well as consequent 
      residual problems and complications.
FAU - Nejadkazem, Mohammad
AU  - Nejadkazem M
AD  - Department of Otolaryngology, Tabriz University of Medical Sciences, Tabriz, 
      Iran. nejadkazem@yahoo.com
FAU - Totonchi, Javad
AU  - Totonchi J
FAU - Naderpour, Masood
AU  - Naderpour M
FAU - Lenarz, Minoo
AU  - Lenarz M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Arch Otolaryngol Head Neck Surg
JT  - Archives of otolaryngology--head & neck surgery
JID - 8603209
SB  - IM
MH  - Adult
MH  - Cholesteatoma, Middle Ear/epidemiology/*etiology
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Iran/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Tympanic Membrane Perforation/*surgery
MH  - Tympanoplasty/*adverse effects/methods
EDAT- 2008/05/21 09:00
MHDA- 2008/06/06 09:00
CRDT- 2008/05/21 09:00
PHST- 2008/05/21 09:00 [pubmed]
PHST- 2008/06/06 09:00 [medline]
PHST- 2008/05/21 09:00 [entrez]
AID - 134/5/501 [pii]
AID - 10.1001/archotol.134.5.501 [doi]
PST - ppublish
SO  - Arch Otolaryngol Head Neck Surg. 2008 May;134(5):501-2. doi: 
      10.1001/archotol.134.5.501.