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November 1968

Malleomyringoplasty: Reconstruction of the Tympanic Membrane and the Handle of the Malleus

Author Affiliations

Cape Town, South Africa
From the Somerset Hospital, Cape Town, South Africa.

Arch Otolaryngol. 1968;88(5):463-468. doi:10.1001/archotol.1968.00770010465003

A SIMPLE method of reconstructing the tympanic membrane and the handle of the malleus as an integrated unit in cases where these structures have been destroyed by infection or by surgery, is presented in this preliminary report.

Construction of the composite unit, accomplished by interposing a perforated bone graft between two layers of temporalis fibrous tissue, is intended to permit the surgeon to utilize the incorporated malleus replacement bone graft to which a wire prosthesis can be attached, as the key architectural structure for all degrees of ossicular reconstruction. This includes the following varieties of disruption which are either extremely difficult or impossible to reconstruct by the current bone or cartilage interposition methods1-5: (1) Cases presenting with only a stapes or stapes remnant situated in a deep narrow oval window niche, partially obscured by an overhanging facial nerve. (2) Cases in which the stapedial footplate is so thick and

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