Wheel-shaped cartilage-perichondrium composite graft for the prevention of retraction pocket development

Abstract

CONCLUSION: Our technique can decrease the formation of retraction pockets and improve hearing function. The wheel-shaped cartilage-perichondrium composite graft (Wheel CPCG) can be considered a good material for a drum graft, and it is easy to insert a ventilation tube, in case of initial drum retraction. OBJECTIVE: The purpose of this study was to introduce the novel surgical technique of a Wheel CPCG with one-stage ossiculoplasty to prevent a retraction pocket and subsequent cholesteatoma after intact canal wall tympanomastoidectomy. PATIENTS AND METHODS: A total of 47 patients were reviewed; 43 cases were selected for audiologic testing. The results of operations were evaluated by comparing preoperative and postoperative hearing results and postoperative drum findings. RESULTS: A retraction pocket was observed in three cases (6.7%). Slight protrusion of partial ossicular replacement prosthesis (PORP) and lateral healing of drum was observed in one case each, and there were two cases of postoperative infection. The number of cases with an air-bone gap (ABG)<20 dB increased from 9 (23%) cases before operation, to 20 cases (51%) after operation. The ABG average statistically decreased from 30.0 dB to 24.0 dB, and the mean air conduction thresholds decreased from a preoperative level of 47.3 dB to a level of 35.7 dB.