RESUMEN
BACKGROUND: While mastoid obliteration techniques have received much attention in decreasing the disadvantages associated with the resultant mastoid cavity from canal wall down procedures, techniques for an anatomically normal looking ear canal reconstruction to increase the feasibility of hearing aid fitting are less commonly discussed as an alternative. METHODS: Our mastoidoplasty technique basically utilises an inferiorly based periosteal flap with or without temporalis muscles and fascia to obliterate the epitympanum and reconstruct the external auditory canal (EAC). Stay sutures are used to keep them in place. For larger cavities, demineralized bone matrix (DBM) is used to obliterate the mastoid cavity and support the neo-EAC. CONCLUSIONS: The concept of our mastoidoplasty potentially provides a very useful alternative in recreating a near normal ear canal anatomy avoiding cavity problems as well as facilitating hearing aid fitting with canal type hearing aids after canal wall down mastoidectomy.
Asunto(s)
Conducto Auditivo Externo , Apófisis Mastoides , Mastoidectomía , Colgajos Quirúrgicos , Humanos , Mastoidectomía/métodos , Conducto Auditivo Externo/cirugía , Apófisis Mastoides/cirugía , Procedimientos de Cirugía Plástica/métodos , Masculino , Femenino , Adulto , Persona de Mediana EdadRESUMEN
The aim of this study is comparative assessment of of different bone-plastic materials for mastoidoplasty. The study included 30 patients who underwent 'canal wall down' mastoid surgery with mastoidoplasty. The following criteria were used for comparing: 1) simplicity of modeling of the material 2) the wound healing process 3) osteointegration - the process of formation of 'new bone' tissue (CT of temporal bones 6 and 12 months after oreretion). It was confirmed that the main groups of bone-plastic material (bioglass, composite materials and ß-tricalcium phosphate) is suitable for mastoidoplasty after 'canal wall down' mastoid surgery.
Asunto(s)
Apófisis Mastoides , Plásticos , Huesos , Humanos , Apófisis Mastoides/cirugía , Hueso Temporal , Cicatrización de HeridasRESUMEN
The objective of the present study was to evaluate the possibility of the application of the cyanoacrylate-based glue for the strengthening of the reconstructed elements of the middle ear and its influence on the regeneration of the cartilaginous tissue. We used the cartilaginous tissue from the auricles of the male California rabbits as a model. The cartilage was destroyed in a standard press. Half of the cartilage thus fragmented was implanted into the left auricle. The remaining part was mixed up with the cyanoacrylate glue and implanted into the right auricle of the same animal. The implanted material was used for the morphological study on day 10, within 1 and 2 months after the beginning of the experiment. The results of the study confirm the absence of the toxic action of the biologically compatible cyanoacrylate-based glue on the regeneration of the cartilaginous and connective tissues which suggests the possibility of its application for the surgical treatment of the diseases of the middle ear.