Tympanic membrane retraction: An endoscopic evaluation of staging systems

@article{James2012TympanicMR,
  title={Tympanic membrane retraction: An endoscopic evaluation of staging systems},
  author={Adrian L. James and Blake C. Papsin and Keith Trimble and James D. Ramsden and Nadarajah Sanjeevan and Neil Bailie and Neil K. Chadha},
  journal={The Laryngoscope},
  year={2012},
  volume={122}
}
The objectives of this work were to assess inter‐ and intraobserver variability of different staging systems for tympanic membrane (TM) retraction using otoendoscopy in children at risk of retraction from cleft palate, to compare hearing level with stage of retraction, and to propose optimum characteristics for monitoring TM retraction with endoscopy. 

Tympanic Membrane Retraction Pockets

Epidemiologic studies already done on the frequency of tympanic membrane retractions have been rare and almost exclusively exploring pediatric populations, finding the frequency in the presence of otitis media is significantly higher.

Tympanic membrane retraction pocket staging: is it worthwhile?

Proper management of TMRPs requires a reproducible, easily applicable staging system with low inter- and intra-observer variability, and a management algorithm is proposed that considers the functional handicap of the patient rather than the topographic description of the TM.

In response to Tympanic membrane retraction: an endoscopic evaluation of staging systems

It is recognized that local resource issues, such as availability of operating room time and ease of access to follow-up, are likely to influence decision making, and also that a different perspective may be appropriate in persistent tympanic membrane retractions in adults.

Ten Top Considerations in Pediatric Tympanoplasty

  • A. JamesB. Papsin
  • Medicine
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 2012
10 important considerations in pediatric tympanoplasty that focus on these differences and help to optimize the chance of successful outcome are reviewed.

Management of tympanic membrane retractions: a systematic review

This study provides all the studies that have been published on the surgical management and wait-and-policy for tympanic membrane retractions and provides the primary outcomes of this study were clinical remission of the tympanoplasty, perforations and cholesteatoma development.

In reference to Tympanic membrane retraction: an endoscopic evaluation of staging systems

The authors correctly note that the presence of granulation tissue and keratin tracking out of a retraction pocket indicate instability and possibly perforation in the retraction, which should be taken into consideration for early surgery, especially the extent of fixation to the promontory.

Endoscopy on Otology - In Retrospect and Prospects

Nepalese Journal of ENT Head and Neck Surgery, Vol. 3 Issue 1 (Jan-June 2012) Page 21-23 DOI: http://dx.doi.org/10.3126/njenthns.v3i1.8185

Natural History of Tympanic Membrane Retraction in Children with Cleft Palate.

Most tympanic membrane retractions remained stable or improved over time in this cohort of children who were at a risk of persistent eustachian tube dysfunction, justifying the conservative approach taken to manage these retractions.

Endoscopic middle ear surgery in children.

  • A. James
  • Medicine
    Otolaryngologic clinics of North America
  • 2013

Long-term results and prognostic factors of underlay myringoplasty in pars tensa atelectasis in children.

Tensa retraction resulting in a tympanic disruption can be cured by underlay myringoplasty with perichondrium or temporalis fascia with results similar to those of simple tyMPanic perforations without recurrent retraction even in the long-term period.

References

SHOWING 1-10 OF 20 REFERENCES

The surgical treatment of atelectatic ears and retraction pockets in children and adults

On the average, 50–55 months of postoperative follow-up showed that atelectasis, once operated, shared the same pattern and prognosis in the children as in the adults.

Re: The Sadé and Tos staging systems: not adequately reliable methods of staging retraction of the tympanic membrane?

  • M. BhuttaM. Haggard
  • Medicine
    Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
  • 2010
The author agrees with Pothier’s two chief conclusions concerning retraction: that otoscopy in many past studies was probably inaccurate, and that gradation of retraction in decisions on treatment is limited by poor inter-observer reliability.

The Erasmus Atelectasis Classification: Proposal of a New Classification for Atelectasis of the Middle Ear in Children

A new classification oflectasis is introduced, which enables a more clinically relevant correlation between stage of disease and clinical sequelae and technical difficulty at surgery.

The eustachian tube. Update on anatomy, development, and function.

  • G. Licameli
  • Medicine
    Otolaryngologic clinics of North America
  • 2002

Erosion of the incus in pediatric posterior tympanic membrane retraction pockets without cholesteatoma.

The Sadé and Tos staging systems: not adequately reliable methods of staging retraction of the tympanic membrane?

  • D. Pothier
  • Medicine
    Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
  • 2009
Analysis of data from the National Audit may reveal interesting differences between racial groups, smokers and non-smokers, and alcoholic drinkers, in SNOT22 scores, which may show that some races do indeed have more SNOT than others.

Limited knowledge and recall of common staging systems: can we rely on what the clinical record tells us about retraction of the tympanic membrane?

  • D. PothierC. CookeS.B. Ahmed
  • Medicine
    Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
  • 2009
Doubt is cast on the reliability of staging of retractions that are recorded in the clinical record and a simple, reliable staging system for the retraction of the tympanic membrane are required.

Atelectasis, retraction pockets and cholesteatoma.

The condition of most ears improved or became stabilized, while in others (the minority, 10–20%) it deteriorated, and the deterioration trend showed a progression from mild atelectasis all the way to deep retraction pockets.

Pars Tensa and Pars Flaccida Retractions in Persistent Otitis Media With Effusion

  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2001
There is minimal evidence to support the concept that pars tensa or pars flaccida retractions are a strong or relevant marker for the severity or evolution of OME in children with otitis media with effusion.

Classification and surgical treatment of fibroadhesive otitis.

Surgical treatment for fibroadhesive otitis was performed in thirty-seven ears, with healthy and thin mucosa in fifteen cases, and among them very good functional results (air-bone gap less than or equal to 10 dB) in seven cases.