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Osteoradionecrosis of tympanic bone: reconstruction of outer ear canal with pedicled skin flap, combined with hyperbaric oxygen therapy, in five patients

Published online by Cambridge University Press:  16 July 2009

M Metselaar*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
A G Dumans
Affiliation:
Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
M P C van der Huls
Affiliation:
Institute for Hyperbaric Medicine, Hoogeveen, The Netherlands
W Sterk
Affiliation:
Institute for Hyperbaric Medicine, Hoogeveen, The Netherlands
L Feenstra
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
*
Address for correspondence: Dr Mick Metselaar, Erasmus MC, Dept of Otolaryngology, Head and Neck Surgery, ’s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. E-mail: r.m.metselaar@erasmusmc.nl

Abstract

Objective:

To evaluate the results of one-stage surgical repair of the meatal skin defect in patients with long-lasting osteoradionecrosis of the outer ear canal, using a postauricular, inferiorly pedicled skin flap. All patients were also treated with hyperbaric oxygen both pre- and post-operatively.

Methods:

A prospective study evaluating the results of a one-stage surgical procedure to repair the meatal skin defect in five patients with osteoradionecrosis of the outer ear canal. All patients were treated with hyperbaric oxygen both pre- and post-operatively.

Results:

In four of the five patients, intact canal skin was achieved after surgery and hyperbaric oxygen therapy. One patient needed a second operation to cover a small remaining area of bare bone. In one patient, wound healing was unsatisfactory and an area of bare bone remained.

Conclusion:

In cases of osteoradionecrosis of the outer ear canal, the skin defect can be repaired with an inferiorly pedicled skin flap. Although not yet scientifically proven, the peri-operative application of hyperbaric oxygen may be of additional value to improve wound healing in areas of compromised tissue.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

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