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Review
. 2023 Mar;280(3):1081-1087.
doi: 10.1007/s00405-022-07573-7. Epub 2022 Aug 10.

Mastoidectomy in surgical procedures to treat retraction pockets: a single-center experience and review of the literature

Angelo Immordino  1 , Pietro Salvago  2 , Federico Sireci  3 , Francesco Lorusso  3 , Palmira Immordino  4 , Dario Saguto  5 , Francesco Martines  2 , Salvatore Gallina  3 , Francesco Dispenza  3
Affiliations
Review

Mastoidectomy in surgical procedures to treat retraction pockets: a single-center experience and review of the literature

Angelo Immordino et al. Eur Arch Otorhinolaryngol. 2023 Mar.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Mastoidectomy; Retraction pocket; Tympanic atelectasis; Tympanoplasty.

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Conflict of interest statement

All authors declared no support from any organization for the submitted work, no financial relationships with any organizations that might have an interest in the submitted work and no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig. 1
Fig. 1
Preoperative left otoscopy, grade III RP with "not-visible fundus" and ossicular chain erosion
Fig. 2
Fig. 2
Postoperative left otoscopy, grade III RP with "not-visible fundus" and ossicular chain erosion managed with RP excision, reconstruction with temporalis muscle fascia reinforced with tragal cartilage and reshaped autologous incus
See this image and copyright information in PMC

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