Tragal Cartilage Reconstruction of the Auditory Canal

THE ADVANTAGES of preservation of the bony posterior wall of the external auditory canal during surgery for chronic infection have been stressed by many authors.1-4Unfortunately this part of the external canal is often partially destroyed by infection or cholesteatoma or must necessarily be removed to ensure adequate control of attic or mastoid pathology. Attempts to repair the resultant defect have been frustrated by numerous problems. Muscle flaps or muscle-periosteal flaps placed in the mastoid cavity were inevitably found to shrink and retract, producing secondary retraction of the canal wall. Some surgeons have reported success in preventing the formation of a mastoid cavity by filling the cavity with autografts, homografts, and even alloplastic implants. An excellent review of the materials used to obliterate the mastoid cavity has been compiled by Merifield.5He found that autograft cartilage survived very well in the cavity and stated: "Cartilage apparently possesses