Effect of the tympanostomy tube on postoperative retraction of the soft posterior meatal wall caused by habitual sniffing.

OBJECTIVES/HYPOTHESIS: To evaluate the effect of the tympanostomy tube (TT) on postoperative retraction of the soft posterior meatal wall caused by habitual sniffing following ear surgery, including a mastoidectomy and soft-wall reconstruction of the posterior meatal wall.

STUDY DESIGN

Retrospective chart review.

METHODS

Sixty-six ears of 64 patients with acquired cholesteatoma who underwent staged ear surgery with a soft-wall reconstruction method and mastoidectomy were enrolled; 26 out of 66 ears had habitual sniffing (sniffing positive[+]), underwent TT placement (TT positive[+]) during surgery, and were followed up for at least 8 months after surgery. Sixty-six ears were divided into sniffing+/TT+, sniffing negative(-)/TT+, and sniffing-/TT- groups, and the degree of the retraction was compared among the three groups.

RESULTS

The distribution of the grades of the postoperative retraction of the soft posterior meatal wall was almost the same among the three groups (P = .60). Ears with severe retraction were found in 19.2% (5/26), 33.3% (7/21), and 15.8% (3/19) in the sniffing+/TT+ group, sniffing-/TT+ group, and sniffing-/TT- groups, respectively.

CONCLUSIONS

The TT was found to be effective in preventing the development of postoperative retraction of the reconstructed soft posterior meatal wall and tympanic membrane among cases with habitual sniffing. We would suggest that TT placement is recommended during surgery for cholesteatoma if a patient was found to engage in habitual sniffing.