“V” Shape Autologous Cartilage Ossiculoplasty for Total Recontruction of the Chain after Cholesteatoma Surgery

By June 7, 2019

Villari, Domenico1
1 ENT Department Modena University, Modena, Italy.

The main goal of cholesteatoma surgery is to eradicate the patology and to avoid possibly any recurrence. A growing interest regarding hearing outcome after surgical removal is shown by the literature. Different type of ossiculoplasty are performed.  The reconstruction can be achieved in one time during first operation or during II look after usually one year, if the pahtology is extended.

The materials used to replace or reconstruct the continuity of the chain are different. Artificial prosthesis are made of plastipore, ceramics, titanium and hydroxyapatite have a higher risk of extrusion while autologous or homologus bones (usually incus) or tragus cartilage seems to be more stable overtime but sometimes tend to be reabsorbed.

4 patients, treated for cholesteatoma surgery. 2 child and 2 adult. 2 treated in one stage surgery, 2 treated during second look. All surgery ware performed with exclusive endoscopic approach

a “” V”” shape autologous prosthesis was built with tragus cartilage. both side of perichondrium was preserved. the autologous prosthesis was positioned between the handle of the malleus and the footplate.

No main complications were described after the surgery. all patients were discharged after one day.

The main follow up was 9 months. All patients were checked with Audiometric Test after 6 months and after one year. All patients had a recovery of hearing function with Air/Bone gap less than 20 dB.

The small case series presented needs more patients and longer follow up to be validated,but the first report was ancouraging for the semplicity of esecution and the availability of the material