Postinflammatory Medial Meatal Fibrosis: Histopathologic Features and Outcomes of Surgical Management

Mantsopoulos K, Thimsen V, Müller-Hübner S, Sievert M, Goncalves M, Iro H, Agaimy A, Hornung J (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Ent-Ear Nose & Throat Journal Mci Medquest Communications Inc

Abstract

Objectives: The aims of our study were to investigate the clinical and audiometric outcome of the surgical treatment of postinflammatory medial meatal fibrosis (PIMMF) and to review the histopathologic changes in the specimens of the fibrotic plug, in order to try to shed light on the pathogenesis of the disease. Materials and Methods: The clinical records and the histopathologic specimens of all patients who underwent tympanomeatoplasty for PIMMF at the ENT Clinic of the University of Erlangen between 2006 and 2020 were evaluated retrospectively. Results: Thirty-four patients (41 primary surgical procedures) made up our study cohort. Of this, 28 cases were managed by means of meatoplasty and 13 cases with tympanomeatoplasty. The mean preoperative air–bone gap (ABG) was 27.8 dB (10-44 dB). Postoperative ABG was significantly improved compared to preoperative values at both short- and long-term follow-ups (P <.001 for both). No significant difference was noted between short-term and long-term ABG (P =.240). An ABG ≤20 dB was achieved in 65.8% of patients (short term) and 50% (long term). The overall rate of revision surgery for restenosis was 29.3% (12/41). Histopathologic reevaluation of the fibrotic plugs revealed a mosaic of patterns with frequent occurrence of secondary cholesteatoma-like lesions and keloid-like tissue changes. Lichenoid submucosal inflammation and increased ectopic ceruminous gland lobules were seen less frequently. Discussion: The moderate long-term outcome of surgical management and the identification of histologic changes with therapeutic implications might pave the way for alternative nonsurgical treatment options.

Authors with CRIS profile

Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery Vivian Thimsen Department of Otorhinolaryngology – Head and Neck Surgery Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery Miguel Goncalves Medizinische Fakultät Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Abbas Agaimy Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie Joachim Hornung Department of Otorhinolaryngology – Head and Neck Surgery

How to cite

APA:

Mantsopoulos, K., Thimsen, V., Müller-Hübner, S., Sievert, M., Goncalves, M., Iro, H.,... Hornung, J. (2021). Postinflammatory Medial Meatal Fibrosis: Histopathologic Features and Outcomes of Surgical Management. Ent-Ear Nose & Throat Journal. https://doi.org/10.1177/01455613211001134

MLA:

Mantsopoulos, Konstantinos, et al. "Postinflammatory Medial Meatal Fibrosis: Histopathologic Features and Outcomes of Surgical Management." Ent-Ear Nose & Throat Journal (2021).

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