Combined Heermann and Tos (CHAT) technique in cholesteatoma surgery: surgical technique and preliminary results

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dc.authoridUZUN, CEM/0000-0003-3233-7049
dc.authoridTas, Abdullah/0000-0002-5689-087X
dc.authorwosidUZUN, CEM/K-3307-2012
dc.contributor.authorUzun, C
dc.contributor.authorYagiz, R
dc.contributor.authorTas, A
dc.contributor.authorAdali, MK
dc.contributor.authorKoten, M
dc.contributor.authorKarasalihoglu, AR
dc.date.accessioned2024-06-12T10:56:21Z
dc.date.available2024-06-12T10:56:21Z
dc.date.issued2005
dc.departmentTrakya Üniversitesien_US
dc.description4th Balkan Congress of Otorhinolaryngology -- SEP 30-OCT 03, 2004 -- Sunny Beach, BULGARIAen_US
dc.description.abstractThe combined Heermann and Tos (CHAT) technique is the combination of Heermann's 'cartilage palisade tympanoplasty' and Tos's 'modified combined approach tympanoplasty = modified intact canal wall mastoidectomy'. The first author (Cem Uzun) performed the CHAT technique as a one-stage operation in 15 ears of 15 patients with cholesteatoma. Two patients (one with a follow up of less than six months and one who did not show up at the final re-evaluation) were excluded from the study. Median age in the remaining 13 patients was 37 years (range: 14-57 years). Cholesteatoma type was attic, sinus (Tos tensa type 1) and tensa retraction (Tos tensa type 2) in six, five and two ears, respectively. Cholesteatoma stage was Saleh and Mills stage 1, 2, 3, 4 and 5 in one, three, four, four and one ear, respectively. The eustachian tube was not involved with cholesteatoma in any ear. After drilling of the superoposterior bony annulus, transcanal atticotomy with preservation of thin bridge and cortical mastoidectomy with intact canal wall, the cholesteatoma was removed, and the eardrum and atticotomy were reconstructed with palisades of auricular cartilage. Type I tympanoplasty was performed in two ears, type II in nine ears and type III (stapes absent) in two ears, with either autologous incus (eight cases), cortical bone (two) or auricular cartilage (one). No complication occurred before, during or after surgery. Oto-microscopy and audiometry were done before and at a median of 13 months after surgery (mean 14 months, range 7-30 months). There was no sign of residual or recurrent cholesteatoma in any patient during the follow-up period. At the final examination, all ears were dry and had an intact eardrum except one with a small, central hole, which had been seen since the early post-operative period. Clean and stable attic retraction with a wide access was observed in two ears. Post-operative hearing at the final evaluation was better (change > 10 dB) than the pre-operative one in nine ears and did not change in the remaining four. Pre- and post-operative mean hearing values were, pure-tone average 47 and 35 dB (p = 0.01) and air-bone gap 30 and 20 dB (p = 0.02), respectively. With the CHAT technique, cholesteatoma can be completely and safely removed from the middle ear, and a durable and resistant reconstruction of the middle ear with reasonable hearing can be achieved. However, a further study should analyse long-term results of a larger patient group.en_US
dc.identifier.doi10.1258/0022215054273250
dc.identifier.endpage435en_US
dc.identifier.issn0022-2151
dc.identifier.issn1748-5460
dc.identifier.issue6en_US
dc.identifier.pmid15992467en_US
dc.identifier.scopus2-s2.0-21244485852en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage429en_US
dc.identifier.urihttps://doi.org/10.1258/0022215054273250
dc.identifier.urihttps://hdl.handle.net/20.500.14551/19764
dc.identifier.volume119en_US
dc.identifier.wosWOS:000230034300003en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherCambridge Univ Pressen_US
dc.relation.ispartofJournal Of Laryngology And Otologyen_US
dc.relation.publicationcategoryKonferans Öğesi - Uluslararası - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectCholesteatomaen_US
dc.subjectSurgical Proceduresen_US
dc.subjectHearing Lossen_US
dc.subjectCartilage Palisade Tympanoplastyen_US
dc.subjectTensa Retraction Cholesteatomaen_US
dc.subjectAttic Cholesteatomaen_US
dc.subjectIii Tympanoplastyen_US
dc.subjectFasciaen_US
dc.subjectChildrenen_US
dc.subjectSinusen_US
dc.titleCombined Heermann and Tos (CHAT) technique in cholesteatoma surgery: surgical technique and preliminary resultsen_US
dc.typeConference Objecten_US

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