EARLY INTERVENTION OF PARS TENSA RETRACTION POCKETS IN CHILDREN BY CARTILAGE REINFORCED TYMPANOPLASTY

Abstract

Posterosuperior retraction pockets involving pars tensa of a tympanic membrane is not an uncommon
problem particularly in pediatric population. This occurs as a sequelae of chronic otitis media with effusion.
The management options include “wait and watch,†medical treatment and surgery. But in patients in
whom retraction is severe and seems to be irreversible the treatment should be surgery at the earliest. We
performed cartilage reinforced tympanoplasty in 29 ears of 28 children who had grade III and IV
posterosuperior retraction pockets of the pars tensa. Their average pre-operative hearing loss was 16.6 and
19.4dB for grade III and IV retraction pockets respectively with 10 and 12.4dB post operative gain. No
recurrences were noted except few minor complications. We suggest that such procedures are safe and
should be performed at the earliest rather than to keep under surveillance and medical treatment only.

Key Words: Pars tensa retraction pockets, Tympanic membrane atelectasis, atelectatic ear, Tympanoplasty.