[Application of lateral attic wall reconstruction and sealing of attic cell in tympanoplasty].
OBJECTIVE
To observe the effects of lateral attic wall reconstruction and sealing of attic cell in prevention of recurrence of cholesteatoma and limitation of ossicular chain after tympanoplasty.


METHODS
150 cases of chronic tympanitis and mastoiditis were studied. Forty patients with intact ossicular chain after opening mastoidectomy underwent lateral attic wall reconstruction with autologous cartilage of auricular concha (n = 15) or "bone cement plate" made of autologous bone cortex powder adhered by glue of fibrinogen and thrombin (n = 25). Eighty-nine of the 110 cases with damaged ossicular chain underwent reconstruction of ossicular chain and sealing of tympanic cavity with bone powder and glue of fibrinogen and thrombin and fascia of temporal muscle was used to restore the tympanic membrane in 21 of them. Follow-up was conducted for 3 to 5 years to observe the recovery of tympanic membrane, hearing, and whether cholesteatoma recurred.


RESULTS
No recurrent cholesteatoma and serious retracted tympanic membrane were found. Eardrum re-perforated in 8 cases (5.33%). The patients with lateral attic wall reconstruction obtained a significant hearing improvement (97.5%). Hearing was improved among 80.8% of the cases that underwent sealing of attic cell and ossiculoplasty.


CONCLUSIONS
Lateral attic wall reconstruction and sealing of attic cell prevent the recurrence of cholesteatoma. Reconstruction of lateral attic wall provides a new space for vibration of ossicular chain.
Chi
Fanglu
F
Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, China.
Wang
Zhengmin
Z
Wu
Liwen
L
D002781:Cholesteatoma / Q000517:prevention & control*; D004429:Ear Ossicles / Q000502:physiology; D006801:Humans; D014433:Tympanoplasty