Temporalis fascia graft perforation and retraction after tympanoplasty for chronic XXXX and attic retraction pockets: factors associated with recurrence.

@entity1 @entity1244 @entity2346 @entity8021 @entity11818 @entity3137
OBJECTIVES: To correlate the recurrence of temporalis fascia graft perforation and retraction in adults and @entity1 after tympanoplasty for chronic @entity2346 and deep attic retraction pockets with age, pathologic process, @entity3137 , mucociliary transport time, chronic @entity1244 , and lateral attic wall reconstruction. DESIGN: Retrospective study. SETTING: Tertiary referral center. @entity1 : Two hundred seventy-four adult ears and 41 @entity1 ears were operated on for chronic @entity2346 , 50 adult ears were operated on for @entity11818 , and 56 adult ears were operated on for attic retraction pockets. INTERVENTIONS: Underlay tympanoplasty with or without mastoidectomy and lateral attic wall reconstruction for attic retraction pockets. Mucociliary transport time was investigated using @entity8021 testing. MAIN OUTCOME MEASURES: Recurrent perforation, recurrent attic retraction, and temporalis fascia graft retraction were evaluated. RESULTS: Higher incidences of recurrent perforation were found in adults operated on for @entity2346 vs @entity11818 (P = .02) and in @entity1 (P = .004), especially those 9 years and younger (P = .02). A risk factor in adults was chronic @entity1244 (risk ratio, 35.0; 95% confidence interval, 32.1-38.2; P = .004). Temporalis fascia graft retraction correlated with slower mucociliary transport time in adults (P < .001). A lower incidence of recurrent attic retraction was associated with lateral attic wall reconstruction (P < .001). CONCLUSIONS: Recurrent temporalis fascia graft perforation after tympanoplasty for @entity2346 may be related to age and coexisting chronic @entity1244 . Temporalis fascia graft retraction correlates with slower mucociliary transport time in the eustachian tube. Lateral attic wall reconstruction minimizes recurrent attic retraction in adults.
