title: Osteoradionecrosis of tympanic bone: reconstruction of outer ear canal with pedicled skin flap, combined with hyperbaric oxygen therapy, in five patients.
abstract: OBJECTIVE
  To evaluate the results of one-stage surgical repair of the meatal skin defect in patients with long-lasting osteoradionecrosis of the outer ear canal, using a postauricular, inferiorly pedicled skin flap. All patients were also treated with hyperbaric oxygen both pre- and post-operatively.
  
  
  METHODS
  A prospective study evaluating the results of a one-stage surgical procedure to repair the meatal skin defect in five patients with osteoradionecrosis of the outer ear canal. All patients were treated with hyperbaric oxygen both pre- and post-operatively.
  
  
  RESULTS
  In four of the five patients, intact canal skin was achieved after surgery and hyperbaric oxygen therapy. One patient needed a second operation to cover a small remaining area of bare bone. In one patient, wound healing was unsatisfactory and an area of bare bone remained.
  
  
  CONCLUSIONS
  In cases of osteoradionecrosis of the outer ear canal, the skin defect can be repaired with an inferiorly pedicled skin flap. Although not yet scientifically proven, the peri-operative application of hyperbaric oxygen may be of additional value to improve wound healing in areas of compromised tissue.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands. r.m.metselaar@erasmusmc.nl
authors.forename: M
authors.initials: M
authors.lastname: Metselaar
authors.forename: A G
authors.initials: AG
authors.lastname: Dumans
authors.forename: M P C
authors.initials: MP
authors.lastname: van der Huls
authors.forename: W
authors.initials: W
authors.lastname: Sterk
authors.forename: L
authors.initials: L
authors.lastname: Feenstra
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D004424:Ear Canal / Q000601:surgery*; D004431:Ear, External / Q000601:surgery*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000150:complications* / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000592:standards*; D013701:Temporal Bone / Q000473:pathology*; D016896:Treatment Outcome