Abstract
The eardrum is essential for the restoration of hearing in tympanoplasty. At surgery, however, the patient's own eardrum is not always available.
We have recently employed a method of total reconstruction of the eardrum using free fascial graft and gelfilm.
After tympanomastoidectomy, the canal skin is elevated from the medial lateralward, starting near the annulus. Then the bony canal is widened anteriorly and inferiorly. The bony shelf is made adjacent to the annulus using a small cutting burr. It is easy to drill out the canal wall to make a wide shelf without opening the glenoid fossa.
A gelfilm disk is placed on the bony shelf. In cases where the posterior bony wall is removed, the disk is placed on the posterior buttress posteriorly. A free fascial graft is placed on the disk. The elevated canal skin is then put back. There is a tympanic cavity under the disk.
Using this method, it is possible to obtain a new membrane at the original position in cases of total perforation. As the tympanic cavity is not filled with gelfoam, the healing process is rapid.
