Use of titanium in repair of external auditory canal defects.
BACKGROUND
Canal wall defect repairs commonly result from cholesteatoma, surgery for chronic ear disease, or exostosis and also from congenital deformities. Reconstructions of these defects are often difficult and unstable. This article reports the use of titanium sheeting to repair external auditory canal wall defects.


METHODS
Titanium sheeting was used to repair a variety of wall defects. The sheeting was used as a support material, lying deep to the wall defect, which was sealed with an autograft cartilage layer that was fitted to fill the defect. Middle temporal or temporalis fascia vascular flaps were used to cover large-defect repairs to promote rapid healing. The sheeting was used in 56 external auditory canal defect cases, including 35 deep canal defects, 4 lateral bony wall repairs, 12 open-cavity reconstructions, and 5 anterior wall repairs.


RESULTS
There were no evident biomaterial complications, and infection was absent from the series. The sheeting was simpler touse than ceramics, being easily shaped and bent to fit the individual case. Second-look cavity reinspections were simpler than when ceramics or autografts had been used for reconstructions.


CONCLUSIONS
Titanium sheeting has been proven an effective method of canal wall repair when combined with the supplementary techniques used with biomaterials in this role (cartilage cover and vascular flaps). Its ease of use, versatility, and reliability are superior to previous organic or ceramic methods.
Black
Bruce
B
Department of Otolaryngology, Royal Children's Hospital and University of Queensland, Brisbane, Australia. bruceblackmd@bigpond.com
D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use; D002356:Cartilage; D004424:Ear Canal / Q000601:surgery*; D005205:Fascia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps; D014025:Titanium / Q000627:therapeutic use*; D016896:Treatment Outcome
D001672:Biocompatible Materials; D014025:Titanium