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For otitis media patients with severe mucosal lesions, adhesion is the most common poor prognosis of tympanoplasty. We generally consider tympanic cavity adhesion is due to eustachian tube dysfunction and poor middle ear ventilation. The mechanism of adhesion is unclear so far, which we thought is mainly associated with wounded surface and activation of the fibrinolytic system. To solve the problem of adhesion, several materials have been used in the middle ear surgery, such as plastic sheet, silicone sheet and absorbable material. And there are some benefits. The most widely used is silicone sheet, and there are some researches focused on its thickness, shape and components to achieve better anti-adhesion effect. In this article, we will do a review for the research advances of anti-adhesion materials in tympanoplasty.

Objective: To observe the clinical effect on the treatment of intractable tympanitis with reconstruction of external auditory canal wall. Method: Five cases underwent radical removel of residual lesion and reconsruction of external auditory posterior canal wall using hydroxyapatite ceramic wall with transferred pedicle temporalis fascia covering on it were analyzed. The implement of ossicular chain reconstruction depends on the probing for tympanic cavity intraoperatively. Periodic review were conducted in the 1st, 3rd, 6th, 12th month after surgery. Result: All 5 cases gained dryears within 3 months after surgery, in which hearing of 3 cases improved and ABG were within 20 dB. 1 cases showed no improvement compared to preoperation, and 1 case gained a worse audiology result. Central part of the transplant of 1 case was naked, while peripheral part had been epithelization and external auditory canal gained no accessible to mastoid cavity, the patient were also found recurrence of cholesteatom inside the mastoid cavity when received CT examination during outpatient follow-up one year postoperatively, and underwent correction surgery. 1 case underwent revision operation for a fistula between the reconstructed wall and the skin of the outer auditory canal. No surgical complications like infection or facial paralysis occurred, all patients were satisfied with surgery effect. Conclusion: HA with transferred vascularized temporalis fascia pedicle for the reconstructon of the external auditory canal wall is an effective method for the treatment of intractable tympanitis, and worth promoting., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)