Shea J J, Malenbaum B T, Moretz W H
Otolaryngol Head Neck Surg. 1984 Jun;92(3):329-33. doi: 10.1177/019459988409200316.
Many ears with prior radical or modified radical mastoidectomy operations can be rehabilitated by reconstruction of the posterior canal wall with the porous biocompatible implant material Proplast. Many techniques have been advanced for reconstruction of the posterior canal wall and/or obliteration of the mastoid bowl. We prefer reconstruction of the posterior canal wall to obliteration of the mastoid bowl on the theoretical grounds that with obliteration you lose the pneumatic buffer of the mastoid air cell system and you might be burying infection and/or cholesteatoma in the depths of the mastoid. In this article we shall present our results with elimination of the open mastoid bowl by reconstruction of the posterior canal wall with Proplast. A retrospective study of 83 consecutive patients who underwent reconstruction of the posterior canal wall with Proplast during the 5-year period 1974 to 1978 was undertaken. The surgical technique consisted of rebuilding the tympanic membrane, when necessary, repairing the ossicular chain, when necessary, and reconstructing the posterior canal wall. The overall success rate for the posterior canal wall reconstructions was 46% (38 of 83). However, after modifications were made in the technique, especially in the use of thicker fascia and/or perichondria and periosteum over the Proplast, the success rate increased dramatically to 68% (19 of 28).
许多曾接受过根治性或改良根治性乳突切除术的耳朵，可通过使用多孔生物相容性植入材料Proplast重建后鼓室壁来恢复功能。已经有许多技术用于重建后鼓室壁和/或闭塞乳突腔。基于理论上的原因，我们更倾向于重建后鼓室壁而非闭塞乳突腔，因为闭塞乳突腔会失去乳突气房系统的气动缓冲作用，而且可能会将感染和/或胆脂瘤埋入乳突深处。在本文中，我们将展示使用Proplast重建后鼓室壁以消除开放乳突腔的结果。我们对1974年至1978年这5年间连续83例行Proplast后鼓室壁重建术的患者进行了回顾性研究。手术技术包括必要时重建鼓膜、必要时修复听骨链以及重建后鼓室壁。后鼓室壁重建的总体成功率为46%（83例中的38例）。然而，在对技术进行改进后，特别是在Proplast上使用更厚的筋膜和/或软骨膜及骨膜后，成功率大幅提高至68%（28例中的19例）。
