Validation of the efficacy of tympanoplasty combined with cell sheet transplantation.

OBJECTIVE

To evaluate postoperative mastoid aeration following canal wall up tympanoplasty with mastoidectomy combined with autologous nasal epithelial cell sheet transplantation into the middle ear cavity and to compare the outcomes with those of conventional canal wall up tympanoplasty with mastoidectomy.

METHODS

Five patients with acquired cholesteatoma (four pars flaccida types and one pars tensa type) underwent canal wall up tympanoplasty with mastoidectomy combined with autologous cultured nasal epithelial cell sheet transplantation into the middle ear cavity (cell sheet group). Sixty-two patients who underwent conventional canal wall up tympanoplasty without cell sheet transplantation served as the controls. Mastoid cavity aeration was evaluated one year postoperatively using temporal bone CT scans.

RESULTS

All five patients (100%) in the cell sheet group achieved mastoid cavity aeration within 1 year after surgery, and aeration was maintained during the follow-up period. Conversely, only 38.7% (24/62) of patients in the control group demonstrated postoperative mastoid aeration on CT. No adverse events or complications related to the cell sheet transplantation were noted.

CONCLUSION

The combination of canal wall up tympanoplasty with autologous nasal mucosal epithelial cell sheet transplantation achieved adequate aeration of the mastoid cavity 1 year postoperatively. This regenerative approach may improve postoperative middle ear aeration and potentially contribute to the long-term prevention of recurrent cholesteatoma while preserving the physiological structure of the external auditory canal.