[Partial obliteration of radical cavities with ceramic granules]

The canal wall surgery is the safest way to eradicate cholesteatoma. Extensive radical cavities often induced a permanently discharging ear. This article review first of all the common obliteration methods of radical cavities. Since july 1987 to may 1991 we made a partial obliteration of radical cavities with hydroxylapatite granulate in 72 cases. 66 patients were reexaminated. In more than 95% we see a permanent dry cavity, no cholesteatoma recurrence. The ceramic granulate technique is contradicted in fistula of the labyrinth, dissection of the sinus sigmoideus or of the dura. Compared with other relevant techniques (i.e. pedicaled subcutis muscle flaps, free tissue flaps or bone chips) we see no crumpling up of the obliterated areas and no retractions. We have leaved our obliteration technique with homologous cartilage chips because of the possibility of HIV-infection, and longer ear-secretion after cartilage chips.