Conclusions. Habitual sniffing is a significant contributing factor to the development of postoperative retraction of the reconstructed posterior meatal wall and tympanic membrane, although it still seems a multifactorial event. Objective. To examine the possible contribution of habitual sniffing to retraction-type middle ear pathology in a more direct way than previous reports. Patients and methods. The correlation between habitual sniffing and the postoperative configuration of the posterior meatal wall was examined in 58 patients with cholesteatoma who underwent tympanoplasty with reconstruction of the soft meatal wall. Results. The postoperative configuration of the posterior meatal wall showed severe retraction in 7 of 8 patients with habitual sniffing, but only 22 of 47 without habitual sniffing. Habitual sniffing was significantly associated with postoperative severe retraction (Fisher's exact test, p<0.05).
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