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Temporary removal of the posterior bony canal wall with reconstruction using microplate osteosynthesis in cholesteatoma surgery: a case series and description of the technique

  • Otology
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Abstract

We describe the surgical technique of temporary removal of the posterior auditory canal wall with reconstruction and report the outcome of using this technique as a treatment method for cholesteatoma in a case series. In 32 cases of cholesteatoma surgery a technique of temporary removal of the posterior bony wall was applied. During primary surgery the posterior auditory canal wall was removed using an oscillating saw. For the purpose of reconstruction, the canal wall was repositioned and fixed using two titanium microplates (n = 26). In case the canal wall could not be reconstructed with osteosynthesis, either glass-ionomeric cement (BioCem™) was used for fixation (n = 4) or fibrin glue (Tissucol™) (n = 2) to support the posterior wall. The outcome includes the healing process in the first postoperative month, the absence of residual or recurrent disease and the successful reconstruction of the posterior auditory canal wall as evaluated during second-look surgery. When microplates where used, we saw healing problems of the canal skin in about 4 % of patients. Recurrent cholesteatoma was found in 4 cases (14 %), residual cholesteatoma in 8 ears (25 %). In the osteosynthesis group, successful reconstruction was achieved in 25 patients (96 %). In 3 out of 4 patients of the glass-ionomeric cement group (75 %) excessive granulation tissue developed with extensive bony lysis. Temporary removal of the posterior auditory canal wall offers potential for the control of cholesteatoma. Our first results suggest that osteosynthesis allows for a good anatomical and functional reconstruction.

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Acknowledgments

None of the authors have financial interests in relation to this work. No financial support was provided toward the completion of this work.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium

    Karen Van der Gucht, Vincent Van Rompaey, Olivier Vanderveken, Paul Van de Heyning & Jos Claes

  2. Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Karen Van der Gucht, Vincent Van Rompaey, Olivier Vanderveken, Paul Van de Heyning & Jos Claes

Authors
  1. Karen Van der Gucht
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  2. Vincent Van Rompaey
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  3. Olivier Vanderveken
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  4. Paul Van de Heyning
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  5. Jos Claes
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Correspondence to Karen Van der Gucht.

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Van der Gucht, K., Van Rompaey, V., Vanderveken, O. et al. Temporary removal of the posterior bony canal wall with reconstruction using microplate osteosynthesis in cholesteatoma surgery: a case series and description of the technique. Eur Arch Otorhinolaryngol 271, 1497–1503 (2014). https://doi.org/10.1007/s00405-013-2601-2

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  • DOI: https://doi.org/10.1007/s00405-013-2601-2

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