Thiersch Skin Grafting in Otologic Surgery

Xu, Dr. Helen MD
Pollak, Dr. Natasha MD, MS
Paparella, Dr. Michael M. MD

From the Department of Otolaryngology–Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, Calif.
Department of Otolaryngology–Head and Neck Surgery, Temple University School of Medicine, Philadelphia
Paparella Ear, Head and Neck Institute, Minneapolis

Department of Otolaryngology–Head and Neck Surgery, Temple University School of Medicine, Kresge West, 3400 North Broad St., Philadelphia, PA 19140. Email: [email protected]

Ear, Nose & Throat Journal 92(8):p 348-356, August 2013. | DOI: 10.1177/014556131309200808

Thiersch skin grafting is an old but highly effective surgical technique in otology. We frequently place a Thiersch graft after otologic procedures that either create a mastoid cavity or result in reduced skin coverage of a portion of the external auditory canal. The purpose of this article is to introduce this surgical technique to a new generation of otologists. We discuss its indications, the surgical technique, tips for a successful outcome, and postoperative care. A key to successful skin grafting is to perform the procedure about 10 days after the primary procedure to allow sufficient time for the formation of an adequate vascular bed at the recipient site. The goal in all cases is to achieve a safe, dry ear that is covered with keratinizing squamous epithelium. Thiersch grafting accomplishes this very well.