EVEN iVEN with the best of techniques, in tympanoplasties in which several separate pieces of retroauricular skin (Wullstein, cited in Heermann and Heermann1) are used as grafts, seldom does the tympanum heal without a perforation. And equally important, such transplanted skin has a marked tendency toward constant desquamation, later forcing the patients to seek repeated medical attention. Although such desquamation is not seen when only canal skin (Plester, cited in Heermann and Heermann1) is used for the tympanoplasty, this leaves a defect in the epithelium of the auditory canal which in turn leads to difficult postoperative care and, at times, to obstinate stenosis. Moreover, while transplanted skin requires careful placement and depends largely on direct vascularization, fascia and cartilage can thrive for a long time on plasma alone2 and can heal in any desired position, no matter how placed.
We first used temporalis fascia in 1958 to