Use of Micro-Sliced Homograft Cartilage Plates in Tympanoplasty

Histologic study of homograft cartilages implanted in the middle ear

We examined conditions of the micro-sliced homograft cartilages implanted in the middle ear, implanted cartilages removed at revision surgery or implanted cartilages removed at the second stage of staged tympanoplasty, both macroscopically and histologically. Macroscopically, the appearance and shape of the cartilages remained unchanged, with no evidence of erosion. There was no evidence of any foreign body reaction or rejection phenomenon. In general, no marked histologic changes of the matrix tissues were found, although chondrocytes showed degenerative changes. There was partial absorption of cartilage and replacement by fibrous connective tissue when inflammatory changes occurred in the middle ear. It is concluded that implanted homograft cartilage maintains its stiffness for more than 6 months in a healthy, aerated middle ear and appears to be clinically useful for tympanoplasty.

Ceruminous adenoma in the osseous external auditory canal (a case report)

We report a 55-year-old male with cerminous adenoma originating in the osseous part of the right external auditory canal, and describe the clinical features and surgical treatment.

Surgical approach to hearing improvement in the radically operated ear

Our method of improving hearing in patients with old radical cavity is presented. Tympanoplasty is generally indicated for cases of persistent aural discharge with no severe tubal dysfunction. A preserved homologous septal cartilage plate was used to reconstruct the aerated tympanic cavity and to hold the columella material. For cases with insufficient opening of the eustachian tube, planned staged operations were performed following reopening of the tube and insertion of the protuberance part of a silicone plate. Functional results were satisfactory in 12 cases followed up for longer than 2 years (success rate in 80% of the modified type III and in 57% of modified type IV procedure).