J Otolaryngol Ophthalmol Shandong Univ ›› 2013, Vol. 27 ›› Issue (6): 31-34.doi: 10.6040/j.issn.1673-3770.0.2013.083

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Reconstruction of ear canal wall with periosteo-bone graft and postoperative mastoid cavity inflation for huge radical cavity after mastoidectomy

TONG Jun1, LI Ke-yong1, CHEN Wen-wen2, DENG Ya-xin2, CAI Xun-hua2, SHAN Liang2, DU Li-jun2   

  1. 1. Department of Otolaryngology & Head and Neck Surgery, Shanghai First People′s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China; 2. Department of Otolaryngology, Branch of Shanghai First People′s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200081, China
  • Received:2013-03-19 Published:2013-12-16

Abstract:

Objective    To investigate the effectiveness of defect repair of ear canal with autologous periosteo-bone graft and postoperative mastoid cavity inflation. Methods    Clincal data of 43 cases (40 patients) were reviewed. All patients underwent radical mastoidectomy before. The mean pre-operative air conduction (AC) was 68.27±14.13 dBHL, and the mean GAP was 47.02 ± 12.72 dBHL. These cases were further divided into two groups: a) 20 cases received ear ossicle remodeling surgery and the radical mastoid cavity was repaired by periosteo-bone graft; b) The other 23 cases(among them, 3 cases from the former group were re-operated )received additional postoperative mastoid cavity inflation twice per day. Follow-up lasted 9-60 months (mean 16.46±8.36 months). Result s    All ear canals recovered with smooth appearance .In eight cases, postoperative CT scans showed re-gasification of attic and/or mastoid cavity. Compared with the preoperative, postoperative mean AC and GAP were 47.02±12.72 and 23.04±15.30 dBHL, respectively (both P<0.01). The effective rate was 62%(27 cases) and mild effective rate was 37%. In the 3 cases reoperated, poor postoperative hearing  were noted and the adhesion located between the mesotympanum and attic. After the revising surgery, 2 cases gained satisfying GAP. Conclusion    Bone graft containing periosteum can be used to reconstruct the ear canal. Auxiliary inflation of middle ear can promote the attic and/or mastoid cavity re-gasification and hearing recovery.

Key words: Otitis media, Cholestoma; Radical cavity, Ossicle reconstruction, Adhesion

CLC Number: 

  • R764.2
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