Reconstruction of scutum defects (scutumplasty) for attic cholesteatoma.

The use of a small plate of autogenous bone to reconstruct a scutum defect--scutumplasty--in combined approach tympanoplasty in 79 patients with attic cholesteatoma has been studied for a period of one or more years. The bone plate obtained from the mastoid cortex and sculptured to the proper size and shape was snugly fitted between two grooves made by a bur at the anterior and posterior bony external canal wall just proximal to the scutum defect. In this series, recurrence of postoperative cholesteatoma in the attic was found in 5.1%, and retraction pockets, which remained dry and self-cleaning, were seen in 3.8% of the patients. Postoperative hearing results were satisfactory in 68.3%, and hearing was unchanged or deteriorated in 31.7%.