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September 1989

Composite Autograft Cartilage Grafts for Tympanoplasty and Mastoid Surgery

Author Affiliations

Birmingham, Ala

Arch Otolaryngol Head Neck Surg. 1989;115(9):1028. doi:10.1001/archotol.1989.01860330018008

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At the 1989 Triological Society meeting in San Francisco, Calif, Dr Warren Y. Adkins, Charleston, SC, presented his experience using composite autografts for tympanoplasty and reconstruction of canal wall defects. First, he reviewed his early experience with 40 cases that were presented in 1982; he added to these an additional 62 cases utilizing autograft cartilage to prevent retraction and recurrent cholesteatoma associated with posterior retractions (55 cases) and repeatedly failed tympanoplasty (18 cases).

Dr Adkins outlined the technique whereby a groove is created in the ear canal to lock the autograft into position. Perichondrium may help anchor the cartilage in place and, if necessary, acts as graft material should a tympanic membrane or attic defect be present. Only 2 of 62 cases failed, and no recurrent cholesteatoma or retraction pocket developed at the sites. Eustachian tube dysfunction remained a problem in this group, and six patients required intermittent intubation for

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