[The application of autologous conchal cartilage in ossicular chain reconstruction]

To evaluate the efficiency of autologous conchal cartlage in ossicular chain reconstruction in patients with chronic suppurative otitis media.

Seventy-three cases of chronic suppurative otitis media (COM) with or without cholesteatoma who had undergone mastoidectomy with tympanoplasty and ossicular chain reconstruction(OCR) using autologous conchal cartilage as prosthesis were studied retrospectively. Sixty-six cases of COM who had undergone mastoidectomy with tympanoplasty and without OCR were studied as control. The examination of pure tone hearing level of air conduction(AC) and bone conduction(BC) was done before operation, 2 months and 6 months after operation respectively. The pure tone average (PTA) of 0.5, 1.0, 2.0 kHz was observed.

The average air conduction gain was more than 15dB or the PTA (AC) was less than 25 dB 2 months after operation in 35 out of 73 cases who had undergone OCR. Nevertheless, the data became 56 out of 73 cases 6 months after operation. In the control group, The average air conduction gain was more than 15dB or the PTA(AC) was less than 25 dB 2 months after operation in 10 out of 66 cases who had not undergone OCR. The data became 14 out of 66 cases 6 months after operation. In OCR group, air bone gap(ABG) was less than 20 dB in 39 cases 2 months after operation and in 57 cases 6 months after operation. In the control group without OCR, ABG was less than 20 dB only in 11 cases 2 months after operation and in 16 cases 6 months after operation. By statistically analysis, there was significant difference of postoperative hearing improvement between the two groups.

The autologous conchal cartilage can be used as the material of prosthesis for ossicular chain reconstruction in the operation of chronic otitis media. It has many advantages, such as easily--obtained, good histocompatibility, easy to shape and so on.