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December 1960

Skin and Mucous Membrane Grafts in Middle Ear Surgery

Arch Otolaryngol. 1960;72(6):718-721. doi:10.1001/archotol.1960.00740010732003

Surgical restoration of middle ear function in cases of chronic otitis media was facilitated by the introduction of systematic skin grafting. Wullstein, Zöllner, Goto, and others devised—to some extent independently—methods for plastic closure of the tympanum, which were based on auditory-physiological principles.

The tympanic cavity was found to offer favorable conditions for the use of tissue transplants and thus proved a fertile field for experimentation by the otologic surgeon.1,4,5,13 Among the many different plastic procedures advocated in the last few years, we must mention postauricular and meatal pedicle flaps6-8,19 as well as free grafts taken from arm, leg, or abdomen. A full-thickness graft taken from the retro-auricular fold, as recommended by Wullstein,15,16 has found wide and general acceptance. If shaped as in Figure 1, it results in no scarring or deformity.

Although the retroauricular graft appears very suitable, as it contains few elastic fibers or hairs, its