Complex reconstruction of the postoperative cavity in type B1 tympanic paraganglioma using autologous tissues

Abstract

Introduction. Tympanic paragangliomas are rare, highly vascular tumors that can resemble chronic ear infections, which may delay diagnosis and treatment. Removing large tumors can leave wide tissue defects and carries a high risk of bleeding. Safe and effective reconstruction is therefore essential. This paper presents a clinical case of complex reconstruction of a large postoperative cavity using combined autologous tissues. Materials and Methods. We present the case of a 63-year-old woman from an urban area whose symptoms began in 2006. She reported hearing loss, ear pain, pulsatile tinnitus, vertigo, and poorly controlled hypertension. For about 15 years, she was treated for right chronic suppurative otitis media. During this period, she developed severe right-sided ear bleeding that required emergency care. Otomicroscopy showed a red, pulsating mass blocking the external auditory canal. Magnetic resonance imaging revealed a hypervascular lesion (1.1 × 0.9 cm) in the external auditory canal and middle ear. Computed tomography confirmed a type B1 tympanic paraganglioma according to the Fisch classification. The tumor was surgically removed. The postoperative defect was reconstructed by filling the cavity with autologous abdominal fat, placing auricular cartilage for support, and using temporalis fascia to rebuild the tympanic membrane and restore the middle ear. The combined use of these autologous tissues helped control bleeding and reduced the risk of postoperative hemorrhage. Results. The postoperative recovery was good, with no bleeding or infection. The grafts healed well, successfully closing the cavity and providing stable support. The anatomical and clinical outcomes were satisfactory. Conclusions. Reconstruction with abdominal fat, auricular cartilage, and temporalis fascia is a safe and effective method for treating large defects after tympanic paraganglioma removal. Autologous tissues are well tolerated, provide good structural support, and help prevent bleeding complications. This approach is a valuable option in reconstructive ear surgery.