Sudhoff H, Brors D, Al-Lawati A, Gimenez E, Dazert S, Hildmann H
Department of Otorhinolaryngology, Head and Neck Surgery, University of Bochum, Bochum, Germany.
J Laryngol Otol. 2006 Oct;120(10):832-6. doi: 10.1017/S0022215106001927.
To investigate posterior external ear canal wall reconstruction with a composite cartilage titanium mesh graft in canal wall down tympanoplasty and revision surgery for open mastoids.
Retrospective case review.
Tertiary referral centre.
As a preliminary study, 15 selected patients underwent reconstruction of a posterior ear canal wall defect with titanium mesh. Large defects of the posterior external auditory canal wall, resulting from canal wall down tympanoplasty or present in revision surgery, were eliminated by reconstruction using a titanium mesh. The mesh was covered with conchal cartilage and attached to the cortical mastoid bone using 3-mm titanium screws.
All patients maintained a normal contour of the external ear canal, without depression, extrusion or infection. There were no failures, based on short-term post-operative controls. However, two procedures had to be revised due to incomplete coverage of the titanium mesh.
This study shows that reconstruction of the posterior ear canal wall with a composite cartilage titanium mesh is a valuable method for preserving the morphology of the external auditory canal in selected cases. Problems occurring in canal wall down tympanomastoidectomy and radical cavities may therefore be avoided. However, long-term results have yet to be evaluated.
探讨在开放式乳突根治术及外耳道下壁鼓室成形术和翻修手术中，采用复合软骨钛网移植重建外耳道后壁。
回顾性病例分析。
三级转诊中心。
作为一项初步研究，15例选定患者采用钛网重建外耳道后壁缺损。因外耳道下壁鼓室成形术导致的或翻修手术中出现的外耳道后壁大的缺损，通过使用钛网重建得以消除。钛网覆盖耳甲软骨，并使用3毫米钛钉固定于乳突皮质骨。
所有患者外耳道外形保持正常，无凹陷、挤压或感染。根据术后短期检查，无失败病例。然而，有两例手术因钛网覆盖不完全而需再次手术。
本研究表明，在特定病例中，采用复合软骨钛网重建外耳道后壁是保留外耳道形态的一种有效方法。因此，可避免外耳道下壁鼓室乳突切除术和根治性术腔中出现的问题。然而，长期效果尚待评估。
