title: Comparative analysis of effects of reconstruction and radical treatment of the posterior ear canal wall using periosteal osteocomma and mastoid antrum ventilation.
abstract: To analyze the results of repair defect of the ear canal with autologous bone containing periosteum and hearing reconstruction and postoperative inflation. Retrospective analysis of the 40 cases of surgeries conducted by senior surgeon. All cases received full open surgeries. Preoperative air conduction (AC) was 67.47 ± 14.32 dBHL, and GAP was 45.95 ± 12.63 dBHL. These cases were divided into two groups: the first 20 ears received repair surgery for radical mastoid cavity with bone slice containing periosteum combined with ear ossicle remodeling, namely the bone slice group. For another 20 ears, inflator was additionally used and the mastoid antrum cavity was inflated twice a day, namely the inflation group.
  
  
  RESULTS
  9-60 months (median follow-up of 26 months).
  
  
  METHODS
  U test was adopted. All ear canal showed a smooth appearance. Eight cases received CT scans and presenting re-gasification of attic and/or mastoid cavity. Hearing: AC of 47.32 ± 15.63 dBHL, and GAP of 18.28 ± 15.28 dBHL, both P values were <0.01 as compared with that before operation, and the difference was highly significant. 23 cases showed GAP <20 dB, and one case showed GAP >20 at follow-up, but narrowing was >30 dB, and these 24 cases were successful case, with a success rate = 60 %. 16 cases with GAP <10 dB, although 4 cases with GAP >10 dB, narrowing was >30 dB, thus the 20 cases were markedly effective, and with ratio = 50 %. The gap of 30 cases was narrowed more than 15 dB, although two cases showed gap narrowing less than 15 dB, postoperative GAP was less than 10 dB, both were valid, with an efficacy of 32/40 = 80 %, 18 cases (45 %) with AC <40 dBHL. Sub-group analysis: age: group P < 0.05 when the two groups were compared, difference in ages of the two groups were significant, and the age of the inflation group was older. Both GAP and AC of the two groups showed no significant difference before and after the surgery. One case in the bone slice group showed poor postoperative hearing, adhesion was found between the mesotympanum and attic in reoperation, and best result of GAP Close to less than 10 dB was obtained using the decomposition method after inflation. Bone slice containing periosteum can be used for reconstruct the normal ear canal. Auxiliary inflation of middle ear can even promote the tympanic re-gasification and hearing recovery.
authors.affiliation: Department of Otolaryngology of Branch of Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, 200081 China.
authors.forename: Jun
authors.initials: J
authors.lastname: Tong
authors.affiliation: Department of Otolaryngology of Branch of Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, 200081 China.
authors.forename: Wenwen
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology of Branch of Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, 200081 China.
authors.forename: Yaxin
authors.initials: Y
authors.lastname: Deng
authors.affiliation: Department of Otolaryngology of Branch of Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, 200081 China.
authors.forename: Xunhua
authors.initials: X
authors.lastname: Cai
authors.affiliation: Department of Otolaryngology of Branch of Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, 200081 China.
authors.forename: Liang
authors.initials: L
authors.lastname: Shan
authors.affiliation: Department of Otolaryngology of Branch of Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, 200081 China.
authors.forename: Lijun
authors.initials: L
authors.lastname: Du
keywords: Adhesion; Cholesteatoma; Ossicular chain reconstruction; Otitis media