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Facial ridge management in canal wall down tympanoplasty for middle-ear cholesteatoma

Published online by Cambridge University Press:  26 September 2022

V Capriotti Open the ORCID record for V Capriotti [Opens in a new window] ,
E Dal Cin Open the ORCID record for E Dal Cin [Opens in a new window] ,
A Gatto Open the ORCID record for A Gatto [Opens in a new window] ,
P Boscolo-Rizzo Open the ORCID record for P Boscolo-Rizzo [Opens in a new window] ,
G Danesi Open the ORCID record for G Danesi [Opens in a new window]  and
G Tirelli Open the ORCID record for G Tirelli [Opens in a new window]
V Capriotti*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Cattinara Hospital, Trieste, Italy Department of Neurosciences, Section of Otorhinolaryngology and Skull Base Microsurgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
E Dal Cin
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Cattinara Hospital, Trieste, Italy
A Gatto
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Cattinara Hospital, Trieste, Italy
P Boscolo-Rizzo
Affiliation:
Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Italy
G Danesi
Affiliation:
Department of Neurosciences, Section of Otorhinolaryngology and Skull Base Microsurgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
G Tirelli
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Cattinara Hospital, Trieste, Italy
*
Author for correspondence: Dr Vincenzo Capriotti, Department of Otorhinolaryngology, Head and Neck Surgery, Cattinara Hospital, Strada di Fiume 447, 34149 Trieste, Italy E-mail: capriotti.orl@gmail.com
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Abstract

Objective

To estimate whether leaving a high facial ridge during canal wall down tympanoplasty increases the risk of residual cholesteatoma.

Methods

In this retrospective case review, 321 patients treated with primary canal wall down tympanoplasty for middle-ear cholesteatoma were divided into a completely lowered facial ridge group and a non-completely lowered facial ridge group. Factors affecting facial ridge management, residual disease rate and disease-free survival were analysed.

Results

Residual disease rates were 10.8 per cent in the non-completely lowered facial ridge group and 16.6 per cent in the completely lowered facial ridge group (p = 0.15). Localisation at sinus tympani, mesotympanum or supratubal recess, pre-operative extracranial complications, and destroyed ossicular chain or fixed platina were associated with a completely lowered facial ridge. Residual disease rates and disease-free survival did not significantly differ between the groups.

Conclusion

Facial ridge can be managed according to cholesteatoma extension. The facial ridge can be maintained high if the cholesteatoma does not involve sinus tympani, mesotympanum or supratubal recess, without increasing the risk of residual disease.

Keywords

CholesteatomaFacial NerveFacial RidgeTympanoplastyCanal Wall Down Tympanoplasty
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 10 , October 2023 , pp. 1118 - 1125
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr V Capriotti takes responsibility for the integrity of the content of the paper

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