Total middle ear reconstructive surgery for the radicalized ear.

Objective: To evaluate the efficacy of total middle ear reconstructive surgery (TMRS) for patients with open cavity problems. Study Design: Retrospective study of patients treated between 1994 and 1997. Setting: Tertiary care, referral medical center. Patients: Fifty-nine consecutive patients (62 ears) with open cavity problems (draining ears) who underwent TMRS. Main Outcome Measures: Postoperative states of the ears and complications were evaluated in two groups, with and without persistent purulent otorrhea at the time of surgery. Results: In the noninfected group, ears without otorrhea were maintained in 12 (100%) of 12 ears in the short term and 10 (83%) of 12 ears in the long term. In the infected group, the proportions were 40 (80%) of 50 ears and 35 (73%) of 48 ears, for the short and long terms, respectively. Hollowing and/or retraction of the reconstructed canal wall was observed in (8%) of 12 ears of the noninfected group and in 15 (31%) of 48 ears of the infected group after long-term follow-up. Postoperative complications were encountered in 9 ears (14.5%) in the infected group only. Conclusions: Total middle ear reconstructive surgery is considered useful for the management of persistent discharge from radicalized cavities. It was found important to minimize infection at the time of surgery to achieve satisfactory results.