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  Contents > Previous page > Article detail print Order
o Issue N# 5 - 2014 o

OTOLOGY

Total ossicular reconstruction: The "mushroom techni­que"


Authors : Abou Mayaleh H.

Ref. : Rev Laryngol Otol Rhinol. 2014;135,5:221-226.

Article published in english
Downloadable PDF document english



Summary : Objective: The "Mushroom technique" is introduced in this paper as an alternative technique to reconstruct the total ossi­cular chain by using autologous grafts where it is not possi­ble to use the patient’s ossicles, and to seal a peri-lymphatic fistula (PLF) if present. Materials and methods: This non rando­mi­zed retrospective study covers 18 patients aged between 26 and 72 years, operated between January 2006 and March 2012 by the same surgeon using a retro-auricular approach. There were 13 males and 5 females, 12 right ears and 6 left ears. The three ossicles were damaged in 18 patients, a PLF was associated in 3 cases, and a tympanum perforation was present in 2 ears. Postoperative follow-up period was a minimum of 6 months and up to 6.5 years. The origin of 18 patient's disease was; post trau­matic in 11 patients and post removal cholesteatoma in 7 patients. The "mushroom techni­que" was performed for all patients. The average Air Bone Gap (ABG) of each patient was calculated (frequencies 500, 1000, 2000 and 4000 Hz) both pre and 6 months post­operatively. Results: There were no extrusion of the composite graft. In the three cases of PLF; the leak was sealed. And in the two ears with tympanum perforation; the perforation was closed. The average post-operative ABG is 25 dB while it was 45 dB before surgery. Average gain is 20 dB. Non sensorineural hearing loss ocurred. Conclu­sion: This technique has several advantages: The mounting footplate-fascia-connective tissue-bone-cartilage -perichondrium-tympa­num is solid and long lasting, the rate of leak closure in case of PLF is improved; This technique closes the leak, the hearing results are satisfactory, the cost of auto­graft is null and the tolerance is excellent. On the other hand, it might be time consu­ming since it is a delicate looking procedu­re.


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