External ear canal reconstruction in patients with radical mastoidectomy

Abstract

Chronic otitis media with cholesteatoma is still an important subject. Canal wall up (closed), canal wall down (open) and the obliterative cavity techniques are the offered procedures for the surgery of the chronic otitis media with cholesteatoma. Despite the advantages of preserving the normal anatomy and hearing ability, the risk of recurrence of cholesteatoma and revision mastoidectomy is high in the canal wall down procedures. In the open techniques, cavity care and the hearing impaiment are the problems, but the risk of the of the recurrence of cholesteatoma is lower. In recent years, reconstruction of the hearing is as important as the cholesteatoma n choronic otitis media surgery. However, for the recontruction of the hearing and to save the trouble of cavity care, one must create a cavity which is small, dry and restored as much as possible. İn this study our goal was to get a cavity which is dry, smal and together with epithelized EAC in our cases For this purpose in GATA Haydarpaşa training hospital between 1997 and 2000. We performed radical mastoidectomy + external auditory canal reconstruction(EAC) + mastoid cavity obliteration operation to 12 kronik otitis media patients with cholesteatoma..We followed up these patients postoperatily* for 12-36 mouth (ort 19.9)*. In all of our cases; at the end of first month in 3 cases,at the end of third month in 5 cases, at the end of sixth month in 9 cases and at the end of one year in 11 cases we got dry and epithelized EAC. In one case because dirty smelling ear discharge which is not responding to treatment we performed revision mastoidectomy and defected recurrent cholesteatoma filling middle ear in fourteenth month. At the same time bone graft which we used for EAC was resorbed.

We concluded that, during eadical mastoidectomy operations, reconstruction of the EAC via using cortical bone grafting and obliteration of the mastoid cavity via using the temporal muscle is effective against the cavity problem and helps inmaintaining hearing reconstruction compared to the open techniques.