Repair of Focal Posterior Canal Wall Defects Using Bony Plate over the Sigmoid Sinus

Aim To study the effectiveness of repair of focal posterior canal wall defects using bony plate over the sigmoid sinus.

Materials and Methods We performed a retrospective review of seven cases operated at our tertiary care center between January 2015 and August 2017 for repair of posterior canal wall defects.

All seven patients had focal defects in posterior canal wall. These defects were repaired by using bony plate harvested from sigmoid plate after an intact canal wall mastoidectomy. The repair was done after a through clearance of active pathology in the ear in all of these cases. These cases were followed up for a period of 6 months to 1 year.

Results All seven cases had successful repair of the posterior canal wall defect. There was good epithelialization of the external auditory canal and the reconstruction was stable. All of these patients had relief from intermittent otorrhea.

Conclusion This technique of repair is simple, repeatable, and provides an effective physiological reconstruction of the posterior canal wall. Bony sigmoid plate is invariably easily available. The plate of bone has a natural curvature of the canal wall. And in terms of tissue quality, the sigmoid bony plate and posterior canal wall plate were similar.

Clinical Significance In an intact canal wall (canal wall up procedure) inadvertent defect of canal wall must be repaired to avoid intermittent otorrhea and to prevent retraction pockets formation. This technique of repair fulfills this requirement and is cost-effective with good patient compliance.