Unit of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostics, Azienda Ospedaliera Universitaria Policlinico ''Paolo Giaccone'', University of Palermo, Via del Vespro, 133, 90127, Palermo, Italy.
Unit of Audiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics, AOUP Paolo Giaccone, University of Palermo, Via del Vespro, 133, 90127, Palermo, Italy.
Eur Arch Otorhinolaryngol. 2023 Mar;280(3):1081-1087. doi: 10.1007/s00405-022-07573-7. Epub 2022 Aug 10.
Retraction pocket (RP) is a common event affecting the middle ear when a negative pressure within it causes a retraction of a single part of the tympanic membrane (TM). Patients can be asymptomatic or can experience hearing loss, fullness feeling and/or ear discharge. RP can be stable or develop a cholesteatoma; aim of the study was to investigate if mastoidectomy may play a role in the surgical management of patients suffering from RP, both reporting our experience and discussing the existing literature.
Fifty-one patients affected by RP were referred for surgery and randomly divided into two groups. Patients of G1 group underwent tympanoplasty with mastoidectomy, patients of G2 group underwent tympanoplasty only. A systematic review of the literature was then carried out by applying the PRISMA guidelines.
The mean follow-up lasted about 36 months. The G1 and G2 groups reached a postoperative mean air-bone gap (ABG) of 7.1 dB HL and 5.1 dB HL, respectively, with a mean ABG improvement of 13.2 dB HL and 12.4 dB HL. An ABG improvement was observed in the 59.7% of the G1 group and in the 63.2% of the G2 group, respectively (p > 0.5). Only one case of long-term complication was recognized in the G1 group. We combined, integrated and analyzed results of our prospective study with results of the literature review.
Based on the combined results of our study and literature review we may conclude that there is no evident benefit in performing mastoidectomy for the treatment of RP. In fact, no differences in ABG improvement or in RP recurrence were reported between the two groups.
耳咽管退缩（RP）是一种常见的中耳疾病，当其中出现负压时，鼓膜的一个部分会回缩。患者可能无症状，也可能出现听力损失、耳闷感和/或耳漏。RP 可以是稳定的，也可以发展为胆脂瘤；本研究旨在探讨乳突切除术在治疗 RP 患者中的作用，包括报告我们的经验和讨论现有文献。
51 例 RP 患者接受手术治疗，并随机分为两组。G1 组行鼓膜成形术加乳突切除术，G2 组行鼓膜成形术。然后按照 PRISMA 指南进行系统的文献回顾。
平均随访时间约为 36 个月。G1 组和 G2 组术后平均气骨导差（ABG）分别为 7.1dBHL 和 5.1dBHL，平均 ABG 改善分别为 13.2dBHL 和 12.4dBHL。G1 组和 G2 组分别有 59.7%和 63.2%的患者 ABG 改善（p>0.5）。G1 组仅发现 1 例长期并发症。我们将前瞻性研究的结果与文献综述的结果进行了综合、整合和分析。
基于我们的研究和文献综述的综合结果，我们可以得出结论，对于 RP 的治疗，行乳突切除术并没有明显的益处。实际上，两组间在 ABG 改善或 RP 复发方面无差异。
