Mastoid Obliteration with Autologous Costal Cartilage

Abstract

Objective: Autologous cartilage such as conchal cartilage has been commonly used as an obliteration material of the mastoid, however sufficient amount could not be harvested. We evaluate the use of autologous costal cartilage for obliteration of mastoid cavity after canal wall down mastoidectomy. Method: Retrospective review of the patients who underwent mastoid obliteration with autologous costal cartilage after CWD was performed. Costal cartilage was harvested at 7th or 8th rib with middle ear surgery. Pre- and postoperative audiometry, neodrum findings, temporal bone CT and complications including wound infection and canal wall displacements were evaluated. Results: A total of 39 patients (29 women, 10 men) with a mean age of 52.5 years underwent the procedure. The follow-up period ranged from 9 months to 14 months (mean period, 11.4 months). For all cases in the study, complications such as postoperative wound infection, perforation, and canal wall destruction did not develop. Small skin dehiscence at the rib harvest site occurred in one case and healed up with reapproximation of the wound. All except 2 patients showed successful postoperative air-bone gap within 20 dB. Mastoidectomized cavities of all cases were well obliterated in follow-up temporal bone CT. Conclusion: Adequate amount of cartilage could be harvested from the costal cartilage and mastoid obliteration could be successfully performed with normal-shaped canal and hearing improvement. We propose the autologous costal cartilage for an obliteration material of the mastoid cavity after canal wall down procedure.