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  Contents > Previous page > Article detail print Order
o Issue N# 4 - 2014 o

OTOLOGY

Herniation of the temporomandibular joint into the external auditory canal: Our review of 13 cases


Authors : Portmann D, Guindi S, Sribniak I, Arcaute Aizpuru F.

Ref. : Rev Laryngol Otol Rhinol. 2014;135,4:187-190.

Article published in english
Downloadable PDF document english



Summary : Symptomatic dehiscence of the anterior wall of the external auditory canal is only occasionally encountered during otologic surgery. Objective: To propose a technical answer for the reconstruction of anterior wall defects based on the size of the dehiscence. Material and methods: Retrospective study of 13 cases of dehiscence of the anterior wall (9 male and 4 female patients between 30 and 66 years) operated between 1998 and 2010. The pathologies at the cause of the dehiscence were cholesteatoma (2 cases), chronic otitis externa (3 cases), congenital dehiscence (1 case), 5 cases which appeared after a surgery mainly for exostosis (3 of them previously operated in another center) and 2 cases of accidental breach during canal calibration. The size of the defect measured during surgery was “small” (< 4 mm diameter) in 2 cases, “medium” (between 4 and 8 mm) in 8 cases and “large” in 3 (> 8 mm). The reconstruc­tion was performed in 7 cases through the EAC and in 6 cases an anterior approach of the anterior wall of the EAC was used. In all cases, we could insert a graft anteriorly and this was held in place by the pressure exerted by the temporo­mandibular joint. Bone paté and temporalis fascia with in most cases a piece of cortical bone graft was used in all cases. Results: The follow up period ranged from 6 to 24 months. In 10 cases the anatomical result was perfect (in 3 cases we encoun­tered some minor complications but with no clinical conse­quen­ces). In the other three cases there was one with persistent inflam­mation of the exter­nal auditory canal, one case of recur­rence of the laterali­za­tion of the tympanic membrane and one case which required a revision surgery. Conclusion: The recons­truc­tion and the ap­proach are done accor­ding to the size of the defect, whether small, medium or large. Complications and revision surgeries have been minimal.

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