Reconstruction of the posterior auditory canal wall with a hydroxyapatite prosthesis

Reconstruction of the posterior auditory canal wall with a prosthesis of porous hydroxyapatite ceramic is described. The implant material is the inorganic basis of the bone matrix and is remodelled into living bone tissue. Thirty patients in whom the cavity was restored with the technique described were followed for at least 2 years, with an average of 3 1/2 years. There was no extrusion. The use of a periosteal flap and replacement of the remnants of the epithelium of the tympanic membrane and former ear canal were essential for the formation of a good epithelial lining in the new ear canal. Sufficient eustachian tube function is essential for a lasting result, as demonstrated in one patient with a recurrent otitis media. A limited retraction of the new tympanic membrane was observed without recurrent cholesteatoma in two patients.