Application of two-flap technique and bone autograft mastoid obliteration for external auditory canal plasty among canal wall down mastoidectomy

Abstract

Objective To investigate the value of two-flap technique and bone autograft mastoid obliteration for external auditory canal plasty among canal wall down mastoidectomy. Methods The retrospective cross-sectional study was conducted. One hundred and thirty-six ears of 136 patients with chronic suppurative otitis media were enrolled in the Department of Otolaryngology Head and Neck Surgery of the First Affiliated Hospital of Bengbu Medical College from June 2015 to January 2018, including 66 males and 70 females, aged from 5 to 77 years, with a median age of 43.5 years, 78 left ears and 58 right ears. Canal wall down mastoidectomy was performed in all cases, radical mastoidectomy in 29 ears, modified mastoidectomy (Bondy technique) in 5 ears, canal wall down mastoidectomy plus tympanoplasty in 79 ears, intact-bridge mastoidectomy plus tympanoplasty in 23 ears. Two-flap technique for external auditory canal plasty and bone autograft mastoid obliteration for reconstruct of the posterior wall of external auditory canal was used in all cases. Results All patients were followed up from 9 to 39 months. Drying ear rate was 98.5%(134/136), drying ear time was ranged from 1 to 5.6 months, with an average of 1.8 months. No facial paralysis and vertigo were found after operation, and no complications such as infection of external ear canal or auricular cartilage were found. The opening of the external auditory canal and the mastoid cavity were between the normal external auditory canal and the traditional cavity of skeletonization of mastoid. Conclusions For the first time, we reports the two-flap technique for external auditory canal plasty and bone autograft mastoid obliteration for reconstruct of the posterior wall of external auditory canal among canal wall down mastoidectomy is an important, safe and effective procedure for treatment of chronic suppurative otitis media. It is worth application and dissemination. Key words: Otitis Media, Suppurative; Otological surgery; Canal wall down mastoidectomy; Autologous cortical bone; Reconstruction of posterior wall of external auditory canal