Palisade cartilage technique to prevent retraction after one-stage surgery for sinus and tensa retraction cholesteatoma in children

Postoperative retractions of the eardrum are common after surgery for cholesteatoma. The aim of the study is to investigate, if reconstruction of the eardrum with palisade cartilage technique can prevent postoperative retractions and recurrent cholesteatomas. Further the aim is to investigate the postoperative hearing. During the period from June 1995 to October 2000, 32 children with sinus or tensa retraction cholesteatoma underwent one-stage surgery. In all children the eardrum was reconstructed with the palisade cartilage technique. All the patients were re-evaluated recently. The median observation time was 37 months, range 3-36 months. At the last control we found postero-superior retraction in two patients, both operated for sinus cholesteatoma. The palisades were in these cases by mistake not placed in the posterosuperior drilling defect behind the interpositioned incus. None of the patients developed cholesteatoma recurrence. At the follow-up we found no perforations, however one had been re-operated during the observation period due to a small perforation. We conclude, that the palisade technique prevents efficiently postoperative retractions of the eardrum. The postoperative hearing is good.