Use of cartilage plate as tympanic membrane in total middle ear reconstructive surgery for infected radicalized ear.

Objective: To evaluate the usefulness of cartilage plates as tympanic membranes combined with total middle ear reconstructive surgery for radicalized ears. Study Design: Retrospective study between 1994 and 1999. Setting: Tertiary care referral medical center. Patients: Seven patients had seven ears with severe chronic otorrhea after radical mastoidectomy. All patients had severe to profound sensorineural hearing loss and expected a trouble-free ear rather than improved hearing after surgery. Patients were followed up for 4 years postoperatively. Methods: After the middle ear space was cleaned, the tympanic membrane was reconstructed using a plate prepared from the tragal cartilage. The major part of the posterior wall was reconstructed using a conchal cartilage plate. Cortical bone segments were inserted to support the cartilage plate. Results: Preoperatively, cultures of ear discharge were positive for various bacteria. Recovery with dry eardrums was noted in six patients, and one patient showed minimal erosion. No postoperative complications were encountered, but the hearing threshold did not improve postoperatively. Conclusions: Total middle ear reconstructive surgery is suitable for patients with chronic otorrhea complicating radical mastoidectomy. The use of cartilage plates seems to be clinically appropriate, particularly for patients with severe infection who expect a trouble-free ear rather than hearing gain after surgery.