Reconstruction of the mastoid using a titanium cage.

ABSTRACT

OBJECTIVES: Evaluate reconstruction of the posterior canal wall, including the mastoid cavity after canal wall-down cholesteatoma removal. METHODS: A titanium mesh metal cage was used to rebuild the posterior auditory canal wall and mastoid cell system in 12 patients undergoing cholesteatoma removal. The cage was then covered with pieces of cartilage to reconstruct the soft tissue surface. RESULTS: All reconstructions epithelialized completely. There was no denudation of the titanium material or signs of extrusion. Recurrences of cholesteatoma occurred twice according to the condition of the underlying disease, not related to the material. CONCLUSION: The titanium cage showed good biocompatibility in the middle ear space and the potential for rebuilding the mastoid cell system, making it a versatile tool for primary cases with large defects and in revision cases where soft tissue with cartilage-only reconstructions failed. Reconstruction of the posterior canal wall and mastoid by means of a titanium cage can be used in situations where adhesive tensions need a more stable construction and support of the posterior canal wall.