{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T02:51:45Z","timestamp":1791168705449,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The necessity of routine umbo resection during over\u2013underlay tympanoplasty remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate histopathological persistence of epithelial remnants according to perforation\u2013umbo relationship and to estimate the risk of postoperative cholesteatoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective cohort of 148 consecutive Type I over\u2013underlay tympanoplasties with minimum 24\u2010month follow\u2010up. Patients were grouped by perforation relation to the umbo. All resected specimens were examined with haematoxylin\u2013eosin (H&amp;E); pan\u2010cytokeratin immunohistochemistry was not performed in this series. Categorical comparisons used Fisher's exact test; proportions are reported with 95% confidence intervals (CI). Post hoc upper 95% bound for cholesteatoma incidence was calculated using the Poisson approximation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Histopathology revealed epithelial remnants in 33.3% (12\/36; 95% CI 18.6\u201351.0) of Group 1 and 21.9% (7\/32; 95% CI 9.3\u201340.0) of Group 2; none were detected in Group 3. No cholesteatoma developed during mean follow\u2010up of 24\u2009months; the upper 95% confidence bound for true cholesteatoma incidence was 2.02%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Umbo\u2010involving perforations are associated with higher rates of microscopic epithelial remnants, but microscopic remnants did not translate into cholesteatoma within the observed follow\u2010up. Routine umbo resection is not mandatory when meticulous de\u2010epithelialisation is achievable; selective resection based on intraoperative assessment is recommended. Longer follow\u2010up and larger multicentre cohorts are required to exclude rare adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.70165","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T02:10:41Z","timestamp":1791166241000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is Routine Umbo Resection Necessary During Over\u2013Underlay Tympanoplasty? A Histopathological and\u00a0Clinical Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8857-7290","authenticated-orcid":false,"given":"Emrah","family":"G\u00fcnd\u00fcz","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery Inonu University Faculty of Medicine  Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0997-7729","authenticated-orcid":false,"given":"Mehmet Turan","family":"\u00c7i\u00e7ek","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery Inonu University Faculty of Medicine  Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8557-0886","authenticated-orcid":false,"given":"Mehmet","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery Inonu University Faculty of Medicine  Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0707-9984","authenticated-orcid":false,"given":"Mehmet","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery Inonu University Faculty of Medicine  Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8990-0651","authenticated-orcid":false,"given":"\u00c7i\u011fdem F\u0131rat","family":"Koca","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery Inonu University Faculty of Medicine  Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4362-795X","authenticated-orcid":false,"given":"\u0130smail","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery Inonu University Faculty of Medicine  Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-2456","authenticated-orcid":false,"given":"Ay\u015fe Nur","family":"Akatl\u0131","sequence":"additional","affiliation":[{"name":"Department of Pathology Inonu University Faculty of Medicine  Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1047-2872","authenticated-orcid":false,"given":"Gloria","family":"Schiavo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, ASST Lariana, Ospedale Sant'anna University of Insubria  Como Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/S0030-6665(05)70144-4","article-title":"Grafting Techniques","volume":"32","author":"Wehrs R. 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Head & Neck Surgery"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70165","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.70165","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70165","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T02:10:44Z","timestamp":1791166244000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.70165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,4]]},"references-count":16,"alternative-id":["10.1111\/coa.70165"],"URL":"https:\/\/doi.org\/10.1111\/coa.70165","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,4]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"coa.70165"}}