D. Satyanarayana1, G. Madhusudhan Reddy2, Shameera3, S. Muneeruddin Ahmed4, M. Mahendra Kumar5
INTRODUCTION: A variety of organic and inorganic materials is used as grafts in Ossiculoplasty and reconstruction of the outer attic wall and posterior wall of External Auditory Meatus. Tragal cartilage, Conchal cartilage and septal cartilages are frequently used as auto grafts during Tympanoplasty surgery for reconstruction of Ossicular chain. Cartilage grafts used for Ossicular replacement should be thick, sturdy, easily sculpted and without much elasticity. If the graft has elastic nature it tends to reduce the conduction of sound vibrations. Auricular cartilage is accessible through the same post aural incision used for the mastoid surgery. If the auricular cartilage is palpated for the thickness, one would find that the thickest part is the isthmus. It is felt below and posterior to the inter tragal sulcus. The present study is to measure the thickness of the isthmus part of the auricle cartilage. It also includes study of histology of the cartilage of isthmus to observe the stacks of cells present between the two layers of the perichondrium.
MATERIALS AND METHODS: The cartilage of isthmus from 36 cadavers is dissected to measure its thickness and for histology study. Cartilage of isthmus from 36 patients undergoing Modified Radical Mastoidectomy is measured for their thickness and histology is studied. A sterile steel calipers is used to measure the thickness of the cartilage, after exposing the cartilage from posterior aspect during surgery. The tips of the calipers are kept touching the perichondrium on both sides. Thin histology sections are taken after embedding the cartilage in paraffin moulds. Hematoxyline and Eosin stain is used to study the histology. The thickest portion of the cartilage is sculpted to be used as a strut in Type III Tympanoplasty.
OBSERVATIONS: The thickness of the cartilage varied from 2.1 to 3mm. The number of stacks of chondrocytes varied from 5 to 7. The physical nature of the cartilage is sturdy and easily sculpted.
CONCLUSIONS: Cartilage of the isthmus of the auricle is accessible through the same post aural incision used for Mastoid surgery. The thickness and sturdiness is suitable for use as an Ossicular replacement strut.