Vol.95 No.9 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 95 No. 9 September 2002
Mastoid Cortex Plasty Using Bone Pate and
its Effect on Middle Ear Aeration
Naoaki Yanagihara and Yasuyuki Hinohira
(Takanoko Hospital)
Ryosei Minoda
(Kumamoto University)
Otologists have generally paid little attention to the bony defect of the mastoid cortex following a mastoidectomy. To prevent ingrowth of retroauricular soft tissue into the mastoid cavity and to restore the aerated mastoid cavity, we attempted to reconstruct the mastoid cortex with bone paste hardened with fibrin glue in intact canal wall tympanoplasty. In 55 patients with middle ear cholesteatoma, the outcome of mastoid cortex plasty was observed during second stage operation. In 40 patients (72.7％), the mastoid cortex was completely reconstructed and soft tissue ingrowth into the mastoid cavity was perfectly blocked. In the remaining 15 patients (27.3％) defects of varying sizes were found at the site of the drainage tube insertion. However, the defect was small enough not to allow soft tissue ingrowth into the mastoid cavity. To determine the effect of the mastoid cortex plasty, thirty-five patients with cholesteatoma treated by staged surgery were randomly divided into two groups. Seventeen patients received mastoid cortex plasty with scutum plasty and the remaining 18 control patients received only scutum plasty. Restoration of the middle ear aeration was assessed using High Resolution CT scans before both the first stage operation and the second stage operation. Mastoid cortex plasty was significantly effective for the amelioration of the epitympanum, and also provided mastoid cavity aeration. Mastoid cortex plasty using bone paste is a valuable adjunct to mastoidectomy not only for prevention of retroauricular dimple but for restoration of better aeration of the middle ear cavity.
Key words : mastoid cortex plasty, bone pate, middle ear aeration, mastoid cortex, mastoidectomy