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