title: Use of cartilage plate as tympanic membrane in total middle ear reconstructive surgery for infected radicalized ear.
abstract: OBJECTIVE
  To evaluate the usefulness of cartilage plates as tympanic membranes combined with total middle ear reconstructive surgery for radicalized ears.
  
  
  METHODS
  Retrospective study between 1994 and 1999.
  
  
  METHODS
  Tertiary care referral medical center.
  
  
  METHODS
  Seven patients had seven ears with severe chronic otorrhea after radical mastoidectomy. All patients had severe to profound sensorineural hearing loss and expected a trouble-free ear rather than improved hearing after surgery. Patients were followed up for 4 years postoperatively.
  
  
  METHODS
  After the middle ear space was cleaned, the tympanic membrane was reconstructed using a plate prepared from the tragal cartilage. The major part of the posterior wall was reconstructed using a conchal cartilage plate. Cortical bone segments were inserted to support the cartilage plate.
  
  
  RESULTS
  Preoperatively, cultures of ear discharge were positive for various bacteria. Recovery with dry eardrums was noted in six patients, and one patient showed minimal erosion. No postoperative complications were encountered, but the hearing threshold did not improve postoperatively.
  
  
  CONCLUSIONS
  Total middle ear reconstructive surgery is suitable for patients with chronic otorrhea complicating radical mastoidectomy. The use of cartilage plates seems to be clinically appropriate, particularly for patients with severe infection who expect a trouble-free ear rather than hearing gain after surgery.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Japan.
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Ishimoto
authors.forename: Ken
authors.initials: K
authors.lastname: Ito
authors.forename: Masanobu
authors.initials: M
authors.lastname: Shinogami
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamasoba
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Kaga
mesh_terms: D000328:Adult; D001309:Auditory Threshold / Q000502:physiology; D016025:Bone Transplantation / Q000379:methods; D002356:Cartilage / Q000637:transplantation*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000601:surgery; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008417:Mastoiditis / Q000601:surgery*; D008875:Middle Aged; D009225:Myringoplasty / Q000379:methods*; D010034:Otitis Media with Effusion / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D014433:Tympanoplasty / Q000379:methods*