Use of full thickness skin grafts in canalplasty

Split thickness skin grafts have uniformly been used in the past as the tissue of choice to line the external auditory canal during canalplasty. The success rate of STSG has been reported to be approximately 95%. From our experience with institutionalized patients and their special problems, we have observed that STSG appears to have a greater degree of postoperative contracture, exposing epithelialized bone which has less resistance to trauma than the normal tissue of the EAC. With this in mind, a full thickness skin graft was utilized to line the EAC in conjunction with canalplasty. The use of FTSG in the institutionalized mentally retarded patient has shown no evidence of restenosis or recurrent infection, and we feel it is the treatment of choice in this type of patient and should be considered in the occasional patient who fails a split thickness skin graft canalplasty. Longer term follow-up is required to determine whether FTSG should supplant STSG as the tissue of choice in canalplasty.