Komposit çokkırıklı osteoperiostal flep ile mastoid kavile obliterasyonu ve dış kulak yolu rekonstrüksiyonu: On çalışma

Amaç: Açık kavite mastoidektomi uygulandığındabazı kavite sorunları ortaya çıkmaktadır. Çalışmamızda, mastoid kavite obliterasyonu ve dış kulak yolu rekonstrüksiyonu için, kendi geliştirdiğimiz inferiorpediküllü kompozit çokkırıklı osteoperiostal flebi kullanarak açık kavite sorunlarını gidermeyi amaçladık.Hastalar ve Yöntemler: Kolesteatomlu kronik otitismedia tanısıyla radikal mastoidektomi uygulanandört hastaya mastoid kavite obliterasyonu ve dış kulak yolu rekonstrüksiyonu için kompozit çokkırıklı osteoperiostal flep kullanıldı. Ayrıca hastalarda estetik kaygıya neden olmamak için hastaların dördüne de küçükbir meatoplasti uygulandı. Hastalar en az iki yıl takipedildi.Bulgular: Hastalarda oluşturduğumuz yeni dış kulakyolu epitelizasyonu iki ay içinde tamamlandı. Hastaların hiçbirinde kolesteatom, granülasyon ve osteit rekürrensi görülmedi. Ameliyat sonrası temporalkemik tomografilerinde mastoid kaviteyi dolduranyeni kemik oluşumu saptandı.Sonuç: Mastoid kavite obliterasyonu ve dış kulakyolu rekonstrüksiyonunda kullandığımız, kompozitçokkırıklı osteoperiostal flebin altında gelişen neoosteogenesis ile dış kulak yolu anatomisine yakın birkavite elde edildi

External auditory canal reconstruction and mastoid cavity obliteration with composite multi-fractured osteoperiosteal flap: a preliminary study

Objectives: Öpen cavity mastoidectomy techniques cause some cavity problems. We used inferior pedi- cled composite multi-fractured osteoperiosteal flap which is our original surgical approach to obliterate the mastoid cavity and reconstruct the external audi­ tory canal EAC to prevent the öpen cavity problems.Patients and Methods: Composite multi-fractured osteoperiosteal flap was used to obliterate the mas­ toid cavity and reconstruct the EAC in four patients 2 females, 2 males; mean age 34; range 31 to 38 years who previously underwent radical mastoidec­ tomy to treat the chronic otitis media with cholesteatoma. Small meatoplasty was applied in ali 4 patients to relive their aesthetical concerns. Ali our patients were followed up for two years.Results: The epitelization of the new EAC in our patients was complete at the end of the second month.Cholesteatoma, granulation, and recurrence of osteitis didn’t occur in any of the 4 patients. We detected the new bone formation filling the mastoid cavity in the the postoperative temporal bone CT scanning images.Conclusion: We had an almost natural EAC which owed its existence to the neo-osteogenesis that grows behind the composite multi-fractured osteoperiosteal flap which we use to obliterate the mastoid cavity and to reconstruct the EAC.

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