Management of reconstruction materials on second stage operation

• Published in: Otology Japan Vol. 6; no. 2; pp. 129 - 135
• Main Authors: Ikeda, Hiroki, Hosoda, Yasuo, Doi, Tadasi, Tomoda, Koichi, Yamashita, Toshio, Shiraishi, Syugo, Inoue, Noboru
• Format: Journal Article
• Language: English; Japanese
• Published: Japan Otological Society 1996
• Subjects: canal wall reconstruction; cartilage; cortical bone; Guilford flap
• ISSN: 0917-2025; 1884-1457
• DOI: 10.11289/otoljpn1991.6.129

From 1992 to 1994, at Osaka Saiseikai Izuo hospital, 24 tympanoplasties with stage operation were performed. Subjects were 15 ears suffering from otitis media with cholesteatoma and 9 ears with adhesion. The average duration was 9.2 months from the first tympanoplasty to the second stage surgery, and follow-up study was made in 6 to 40 months after the second operation. Bone pate which is mixed bone powder and fibrin glue, auricular cartilage, cortical bone and Guilford flap as a reconstruction material for the external auditory canal wall were investigated. There was no recurrence of cholesteatoma and otorrhea. The incidence of deformation of the auditory canal was 16.6%. The prostheses was fitted 100% in the case with bone pate, 88.2% with cartilage and none with cortical bone. Histopathological findings in bone pate specimens from the second look operation showed bone tissues with osteoid tissue structure forming spongy bone contained fibrous stroma. For the reconstruction of the canal wall defect, bone pate, cartilage, cortical bone and Guilford flap are either useful materials because are viable autograft receiving blood supply via the periosteal pedicle and well adapted into the surrounding tissues. This technique is effective for the reconstruction of the canal wall defect after canal down procedure.