Heermann J
Laryngol Rhinol Otol (Stuttg). 1977 Mar;56(3):267-70.
Experiences with 8029 endaural tympanoplastes show interruption of the self-cleaning process of the endaural epithelium after 366 tympanoplasties with skin grafts. The self-cleaning process may be preserved after fascia temporalis (2325) and cartilage (5338) plasties, because of overgrowth with local epithelium. 16 years after combined fascia temporalis and cartilage tympanoplasty the pieces of cartilage are almost unchanged but the fascia temporalis is more or less thinned to atrophic scars and according to tubal function it shows adhesive retraction pockets or bulging. For 7 years we have not been using fascia any more, but ear cartilage for the tympano-epitympano-antrum-mastoidplasty. Cartilage material not used is kept in a cartilage bank. Recurrence of cholesteatoma will press the cartilage plasty into the external auditory canal, whereas after osteoplasty of the endaural canal wall the patient runs to an uncertain percentage the same risk as before the operation.
8029例耳道内鼓室成形术的经验表明，在366例采用皮片移植的鼓室成形术后，耳道上皮的自清洁过程受到干扰。在采用颞肌筋膜（2325例）和软骨（5338例）进行鼓室成形术时，由于局部上皮过度生长，自清洁过程可能得以保留。在联合颞肌筋膜和软骨鼓室成形术16年后，软骨片几乎没有变化，但颞肌筋膜或多或少变薄为萎缩性瘢痕，根据咽鼓管功能，会出现粘连性回缩袋或膨出。7年来，我们不再使用筋膜，而是使用耳软骨进行鼓室-上鼓室-鼓窦-乳突成形术。未使用的软骨材料保存在软骨库中。胆脂瘤复发会将软骨成形术压入外耳道，而在耳道壁骨成形术后，患者仍有一定比例的与手术前相同的风险。
