Page 60 - Revista Portuguesa - SPORL - Vol 63. Nº2

mastoid in the affected ear (73,6%) and perforations, were the most common
contralateral tympanograms revealed a slight findings. Aural polyps were reported in 21,6%
predominance of type C or B results, (51,7% of of cases and otorrhea was only seen in a small
tested ears). (table 1 and 2) percentage of 4,1% of patients.
Regarding intra-operative findings (table 3), After entering the middle ear/mastoid space,
otoscopy revealed that attic tunnels (66,1% findings were generally congruent with
of patients) and retraction pockets of the those of CT. Surgeons observed facial canal
posterior pars tensa (25,7%), with or without dehiscence in 19,6% of cases and signs of
erosion at the level of the tegmen tympani
Table 1 and lateral semicircular canals in 10,3% and
Pre-operative mastoid CT scans 11,3% of patients, respectively.
The integrity of the ossicular chain was also
Mastoid CT scan
N = 97 assessed. Signs of erosion were encountered
in 86 patients (88,6%). In 41,2% of total cases,
Pneumatized 16,7 %
the stapes suprastructure was affected.
Diploic (some cells) 9,7 % Intraoperative localization of cholesteatoma
Sclerotic 73.6 % (chart 2), according to the STAM classification
system, revealed that the most affected site
Table 2
Pre-operative contralateral tympanograms was the attic (91.9%), followed by mastoid (65%),
tympanic cavity (58,8%), supratubal recess
Contralateral Tympanogram (14,5 %) and the sinus tympani (2.1%). However,
N = 60 cholesteatomas extending only to a single

A 40 % site were observed in just 26.8% of cases. The
As 8,3 % majority of cases extended through multiple
sites (73.2%). The combination of attic, mastoid
B 26,7 %
and tympanic cavity was the most common,
C 25 % corresponding to 30.9% of total cases. There

Table 3
Intra-operative observation findings

Otoscopy Findings in middle ear/mastoid Ossicular chain
Erosion of ossicular
AtWtic Tunnel 40,3% Facial Canal Dehiscence 19,6% chain with stapes 47,4%
preservation
Erosion of ossicular
Attic Tunnel with 25,8% Tegmen Mastoideum 10,3% stapes suprastructure 41,2%
chain including
Tympanic Membrane Retraction pocket in 21,6% Lateral semicircular 11,3% Ossicular chain 11,3%
erosion
perforation
posterior quadrant
intact
canal erosion
of pars tensa
Retraction pocket in
posterior quadrant
of pars tensa with
perforation 4,1%
Posterior perforation 2,1%
Mesotympanic
perforation 3,1%
Otorrhea 4,1%
Aural Polyp 21,6%

164 Revista Portuguesa de Otorrinolaringologia - Cirurgia de Cabeça e Pescoço