International Session 8 Otology-Clinical 3

After a tympanoplasty to remove a cholesteatoma which extends into the attic, a scutumplasty should be performed to prevent recurrence.When a scutumplasty is performed with transcanal endoscopic ear surgery(TEES) , a thinly sliced tragal cartilage is usually used in our department.Unfortunately, the cartilage can shift out of position, and a retraction pocket can form.Moreover, if a second surgery is required, the remaining cartilage can be insufficient.We thus developed an alternative approach to using cartilage.When a transcanal atticotomy(TCA)is performed via TEES, the bony external auditory canal is widened using a chisel and curette which results in the production of bone chips.These bone chips are used with artificial dermis to reconstruct the scutum defect in a procedure called bone-chip scutumplasty(BCS) .BCS is less invasive and preserves cartilage.We performed a prospective study to determine the effectiveness of BCS.Seven patients underwent a BCS after a TCA.During the observation period, a slight retraction of the tympanic membrane was observed in one patient, but not in the remaining patients.BCS appears to be an effective method of scutumplasty.