Preservation of the external ear canal in tympanoplasty

Abstract

For the purpose of eliminating the troublesome mastoid cavity after tympanoplasty, some surgical procedures have been devised, which consist of preservation of the external ear canal, so that the operative mastoid cavity is primarily closed, with the use of fascia, periost or vein as a tympanic graft. Surgical procedures are as follows : At the first place, mastoidectomy is carried out without sacrifice of bony bridge using Shambaugh's endaural incision. Then, the meatal skin incision is made on the posterior canal skin and on it the window is made to see the drum and to prepare the vascular bed on the undersurface of the drum to receive the graft. Thereafter, the drum is separated from sulcus and elevated, but the anterior superior portion is preserved, which serves for reconstructive pro- cedure of the drum by giving the fixed point. After an adequate tympanoplastic procedure is used in accordance with middle ear condition, the drum is repaired with fascia or other tympanic graft on the undersurface of the drum and recon- structed. Such reconstructive procedures as de- scribed above are easily performed through the meatal window which is made on the early stage in operation. Finally the meatal skin is replaced and the window is closed. With these procedures, it seems that nearly normal ear canal and fully satisfactory results in hearing can he obtained. In Addition, healing process is more rapidly and less postoperative after care is needed than in classical tympanoplasty.