Total Middle Ear Reconstructive Surgery for the Radicalized Ear

Abstract

Total middle ear reconstructive surgery is considered useful for the management of persistent discharge from radicalized cavities. It was found important to minimize infection at the time of surgery to achieve satisfactory results.

Histopathological and Inflammatory Features of Chronically Discharging Open Mastoid Cavities

“…Canal-wall-down mastoid surgery is a common procedure to manage cholesteatoma and chronic otitis media . Despite a low rate of recurrence and satisfactory results, more than 20% of patients with an open mastoid cavity experience intermitted or continuous otorrhea, which is often resistant to therapy . It seems that a major problem of unstable cavities is insufficient (re)epithelialization, which is favored by local conditions, unfavorable cavity shape, and size and host factors .…”

“…1,2 Despite a low rate of recurrence and satisfactory results, 3,4 more than 20% of patients with an open mastoid cavity experience intermitted or continuous otorrhea, 5,6 which is often resistant to therapy. 7 It seems that a major problem of unstable cavities is insufficient (re)epithelialization, 8 which is favored by local conditions, unfavorable cavity shape, and size 9,10 and host factors. 11 Recently we presented promising results with the topical treatment of chronically discharging open mastoid cavities with honey gel, which led to less discomfort, otorrhea, inflammation, and infection than conventional eardrops.…”

Histopathological differences in bony destruction of malleus and incus following mastoidectomy

“…2 We have previously described in detail the operative procedure for total middle-ear reconstruction. [2][3][4][5] In short, a typical total middle-ear reconstruction procedure involves the following steps. (1) The infected skin and epithelium covering the open cavity are peeled off from the post-mastoidectomy cavity, and necrotic and granulation tissue removed.…”