Reconstruction of the Anterior External Auditory Canal With Mastoid Cortex Autologous Bone Graft.

MedStar author(s):
Citation: Otology & Neurotology. 42(10):e1614-e1617, 2021 12 01.PMID: 34325454Institution: MedStar Washington Hospital CenterDepartment: Otolaryngology ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Ear Canal | *Temporomandibular Joint Disorders | Bone Transplantation | Ear Canal/su [Surgery] | Humans | Mastoid/su [Surgery] | Retrospective Studies | Temporomandibular Joint Disorders/di [Diagnosis]Year: 2021Local holdings: Available online from MWHC library: 2001 - presentISSN:
  • 1531-7129
Name of journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and NeurotologyAbstract: CONCLUSIONS: Anterior EAC reconstruction with autologous bone grafting can be an effective definitive treatment in TMJ herniation. To our knowledge, this is the first report of the use of bone grafting to reconstruct the canal defect in TMJ herniation.Level of Evidence: V. Copyright (c) 2021, Otology & Neurotology, Inc.INTERVENTIONS: Reconstruction of the anterior EAC with mastoid cortex bone grafting using an endaural approach.MAIN OUTCOME MEASURES: Successful reconstruction of anterior EAC bony defect without recurrence of herniation.OBJECTIVE: To describe the surgical management of temporomandibular joint (TMJ) herniation with external auditory canal (EAC) reconstruction using autologous bone grafting from the mastoid cortex.PATIENTS: Three patients who presented to our Otolaryngology clinic with evidence of TMJ herniation through an anterior EAC defect, both on otoscopy and computed tomography (CT) imaging.RESULTS: All three patients presented with otalgia, hearing loss, and either tinnitus or a clicking sensation with jaw movement. Etiologies for TMJ herniation included osteoradionecrosis following external beam radiation therapy for head and neck carcinoma and iatrogenic injury following multiple tympanoplasties and canalplasties. A mastoid cortex bone graft was placed and secured anterior to the bony EAC defect through an endaural approach. Two patients wore a dental retainer postoperatively to keep the condyle in an open position. After reconstruction, patients reported an improvement in their presenting symptoms. There was no recurrence of TMJ herniation in all cases after 1, 4, and 9 years.SETTING: A tertiary university medical center.STUDY DESIGN: Retrospective case series.All authors: Kim HJ, Lovett BL, Shearer SCOriginally published: Otology & Neurotology. 42(10):e1614-e1617, 2021 Dec 01.Fiscal year: FY2022Digital Object Identifier: Date added to catalog: 2021-11-01
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 34325454 Available 34325454

Available online from MWHC library: 2001 - present

CONCLUSIONS: Anterior EAC reconstruction with autologous bone grafting can be an effective definitive treatment in TMJ herniation. To our knowledge, this is the first report of the use of bone grafting to reconstruct the canal defect in TMJ herniation.Level of Evidence: V. Copyright (c) 2021, Otology & Neurotology, Inc.

INTERVENTIONS: Reconstruction of the anterior EAC with mastoid cortex bone grafting using an endaural approach.

MAIN OUTCOME MEASURES: Successful reconstruction of anterior EAC bony defect without recurrence of herniation.

OBJECTIVE: To describe the surgical management of temporomandibular joint (TMJ) herniation with external auditory canal (EAC) reconstruction using autologous bone grafting from the mastoid cortex.

PATIENTS: Three patients who presented to our Otolaryngology clinic with evidence of TMJ herniation through an anterior EAC defect, both on otoscopy and computed tomography (CT) imaging.

RESULTS: All three patients presented with otalgia, hearing loss, and either tinnitus or a clicking sensation with jaw movement. Etiologies for TMJ herniation included osteoradionecrosis following external beam radiation therapy for head and neck carcinoma and iatrogenic injury following multiple tympanoplasties and canalplasties. A mastoid cortex bone graft was placed and secured anterior to the bony EAC defect through an endaural approach. Two patients wore a dental retainer postoperatively to keep the condyle in an open position. After reconstruction, patients reported an improvement in their presenting symptoms. There was no recurrence of TMJ herniation in all cases after 1, 4, and 9 years.

SETTING: A tertiary university medical center.

STUDY DESIGN: Retrospective case series.

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