Efficacy of Posterior Canal Wall Reconstruction Using Autologous Auricular Cartilage and Bone Pate in Chronic Otitis Media with Cholesteatoma

Abstract

OBJECTIVE: This study was designed to investigate the long-term results using the technique of canal wall up mastoidectomy and reconstruction of the posterior canal wall using bone pate and auricular cartilage in the treatment of chronic otitis media with cholesteatoma. MATERIALS and METHODS: A retrospective review was performed on 42 patients who underwent canal wall up mastoidectomy and posterior canal wall reconstruction at a single institution between November 2005 and November 2012. RESULTS: Of the 42 patients, postoperative tympanic membranes were normal in 38 (90.5%), perforated in 1 (2.4%), and retracted in 3 (7.1%). Mean preoperative and postoperative values of the air-bone gap (ABG) were 29.4 +/- 12.8 and 23.4 +/- 11.7 dB, respectively, which represented a significant average improvement. For patients with ossiculoplasty (n= 24), the mean preoperative and postoperative ABG values were 34.7 +/- 6.0 and 27.5 +/- 8.0 dB, respectively, which also represented a significant average improvement. Thirty-one (73.8%) of the patients were followed up without any complication, but 5 had otorrhea (11.9%), 4 had dizziness (9.5%), and 2 had facial palsy (4.8%). CONCLUSION: A canal wall up mastoidectomy with reconstruction of the posterior canal wall using auricular cartilage and bone pate provides successful preservation of the anatomic structure and a significant improvement in hearing without the long-term disadvantages of a canal wall down mastoidectomy.