Objective To explore the practical restorative procedure for tissue defect in canal wall-down (CWD) tympanoplasty based on a clinical trial. Methods Included in this study were 26 cases, among them 22 cases with cholesteatoma in the middle ear cleft and 4 with chronic suppurative otitis media, all treated by CWD type of tympanoplasty with pedicle retroauricular flap transplanting to repair the tissue defect in the operative cavity. Then, all these cases were followed up for 1 to 15 years to observe the therapeutic outcomes for evaluating the restorative effect on these cases. Results All the flaps were survived among these cases, with their operative cavities all clearing and dried in a period of one month and no granulation growing. During the following up period, it was found that the operated mastoid cavity were almost vanished in all of them, with a slightly wider external auditory meatus present when compared with that of the opposite side, covered with smooth and clear skin on the reconstructed posterior canal wall, and improved postoperative hearing level at different degrees. Conclusions The tissue defect in the operative cavity, met during CWD type of tympanoplasty, can be repaired with a pedicle retroauricular flap in a simple and convenient way to improve the survival rate of the flap to a higher level and to shorten the period of ear drying for avoiding granulation growing in the operative cavity.%目的 探讨开放式鼓室成形术中上皮缺损的有效修复方法.方法 26例开放式鼓室成形术患者,应用耳后带蒂皮瓣一期修复术腔上皮缺损,系统观察修复效果.结果 所有患者皮瓣全部成活,均在1月内干耳,术腔无肉芽生长.术后随访1～16年,全部患者乳突术腔基本消失,外耳道略宽,后壁皮肤光滑、洁净,术后听力均有不同程度提高.结论 对于开放式鼓室成形术中出现的上皮缺损,耳后带蒂皮瓣修复法简单方便,成活率高,有利于缩短干耳时间.
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