Repair effect of xenogeneic acellular dermal matrix during external auditory canal reconstruction after canal wall down mastoidectomy

Abstract

Background: In some cases, there is insufficient external auditory canal (EAC) skin to cover the reconstructed canal wall after canal wall down (CWD) mastoidectomy. Acellular dermal matrix (ADM) can help to repair the skin, mucosa and other epidermal tissue defects.

Aims: To investigate the repair effect of xenogeneic ADM (xeno-ADM) for EAC skin defects.

Material and Methods: We retrospectively analyzed 28 patients who underwent open mastoidectomy combined with canal wall reconstruction and mastoid obliteration in our hospital. The xeno-ADM was used to repair the EAC skin defect. The epithelialization time, dressing change times, complications and hearing improvement post-operation were summarized and analyzed.

Results: Reasons for using xeno-ADM included: 11 (39.3%) cases suffered from extensive middle ear cholesteatoma, three (10.7%) cases suffered from advanced EAC cholesteatoma, eight (28.6%) cases to solve the cavity-related problems, and six (21.4%) patients had a narrow EAC. The postoperative epithelialization time was 5.8 ± 1.6 weeks, and the number of dressing changes was 4.8 ± 1.6 times. There was no xeno-ADM rejection and related complications, the postoperative hearing improvement was statistically significant (p = .013).

Conclusions and Significance: Xeno-ADM could be a safe, effective and simple method for repairing skin defect in the reconstruction of EAC after CWD mastoidectomy.

Chinese abstract

背景：在某些情况下, 管壁向下（CWD）乳突切除术后, 外耳道（EAC）皮肤无法覆盖重建的耳道壁。脱细胞真皮基质（ADM）有助于修复皮肤、黏膜等表皮组织缺损。

目的：探讨异种阿霉素（xeno-ADM）对EAC皮肤缺损的修复作用。

材料与方法：回顾性分析我院28例乳突开放切除联合管壁重建及乳突闭合术的临床资料。采用异种ADM修复EAC皮肤缺损。总结分析了术后上皮化时间、换药次数、并发症及听力改善情况。

结果：应用异种阿霉素的原因包括：重度中耳胆脂瘤11例（39.3%）, 晚期EAC胆脂瘤3例（10.7%）, 解决与空洞相关的问题8例（28.6%）, 狭窄EAC 6例（21.4%）。术后上皮化时间为5.8±1.6周, 换药次数为4.8±1.6次。无异种ADM排斥反应及相关并发症, 术后听力改善有统计学意义（p = .013）。

结论及意义：异种ADM是CWD乳突术后EAC重建过程中修复皮肤的一种安全、有效、简便的方法。

Keywords:

• Xenogeneic ADM
• external auditory canal
• reconstruction
• canal wall down mastoidectomy
• middle ear disease

Disclosure statement

No potential conflict of interest was reported by the authors.