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Tympanum Reconstruction in Lateral Skull Base: Preliminary Report on Classification-Based Technique
Yang Zhao1, Xu Tian1, Ruizhe Yang1
1Department of Otorhinolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
The Laryngoscope
|September 27, 2025
Summary
A new classification system for tympanum reconstruction after lateral skull base surgery helps restore hearing and structural integrity. Most patients maintained acceptable hearing post-surgery, avoiding profound hearing loss.
Area of Science:
- Otolaryngology
- Neurosurgery
- Surgical Reconstruction
Background:
- Lateral skull base lesions often necessitate extensive tympanectomy, leading to tympanic wall defects.
- Reconstruction is crucial for restoring structural integrity, maintaining middle ear aeration, and preserving hearing.
Purpose of the Study:
- To introduce a classification system for tympanum reconstruction.
- To describe corresponding surgical techniques using pedicled muscle flaps.
- To evaluate the structural and audiological outcomes of this approach.
Main Methods:
- Retrospective review of 17 patients undergoing tympanum reconstruction for benign lateral skull base tumors.
- Classification of defects into Type 1 (posterior/inferior) and Type 2 (anterior/superior).
- Reconstruction utilized sternocleidomastoid or temporalis muscle flaps; outcomes assessed via CT scans and audiological tests.
Main Results:
- All 17 patients achieved well-aerated tympanic cavities post-reconstruction.
- Median postoperative air conduction threshold was 40.0 dB HL, with a median air-bone gap of 25.0 dB HL.
- 82% of patients had postoperative air-bone gaps <30 dB HL; 41% had gaps <20 dB HL, with no significant change from preoperative hearing.
Conclusions:
- A classification-based approach provides tailored tympanum reconstruction for lateral skull base defects.
- Autologous pedicled flaps ensure structural stability and a well-healed auditory canal.
- While hearing gains were not consistent, the method preserves acceptable hearing and avoids profound loss, offering hearing rehabilitation options.
