gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

Reconstruction of the outer ear canal or radical cavity? : comparison of two classical methods in cholesteatoma surgery

Meeting Abstract

  • corresponding author Konrad Schwager - Univ.-HNO-Klinik Würzburg
  • Gerald Baier - Univ.-HNO-Klinik Würzburg
  • Joachim Müller - Univ.-HNO-Klinik Würzburg
  • Jan Helms - Univ.-HNO-Klinik Würzburg

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno023

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2005

© 2005 Schwager et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



The first aim in cholesteatoma surgery is to eradicate the disease and to create a stable outer ear and closed eardrum without draining and recurrent infections. Canal wall down procedures are recognized as safely removing cholesteatoma but either reconstruction of the canal wall or creating a radical cavity is necessary. Both types of surgery may have postoperative healing problems with discharge requiring long term local treatment.

The data base of this investigation included more than 12000 middle ear surgeries. During cholesteatoma surgery in 1646 cases the outer ear canal was reconstructed, in the majority of cases using autologeous cartilage. In 1230 cases a radical cavity was created. The postoperative healing was investigated looking for granulation, discharge and lack of epithelialization. Early data 3 weeks postoperatively show high rates of inflammation in 27 % of reconstruction cases and 21 % in radical cavities, according the post surgery healing process. After 6 months the figures are 5 % for reconstruction cases and 9 % for radical cavities. One year post operation there was still a gap between reconstructed canal walls (5 %) and radical cavities (7 %). Minor reconstructions (1/3 of the canal wall) showed less healing problems than major reconstructions (2/3 and 3/3). In pure tone audiometry (0.5, 1, 2 kHz) the air bone gap was reduced from 28 to 22 dB for reconstructed cases and from 31 to 25 dB for cavities. Major differences between both methods could not be recognized. Because being the more physiological situation we prefer canal wall reconstruction especially in primary cases.