1. Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Ceravital Reconstruction of Canal Wall Down Mastoidectomy: Long-term Results Arch Otolaryngol Head Neck Surg. 2006;132(6):617-623. doi:10.1001/archotol.132.6.617 Artist's rendering of the reconstruction of a mastoid bowl using Ceravital (Ernst Leitz, Wetzlar, Germany; Xomed, Jacksonville, Fla). A, Axial/superior view of the mastoid bowl prior to canal wall reconstruction. B, Lateral view of the mastoid bowl prior to canal wall reconstruction. C, A block of Ceravital is shaped to re-create the posterior external auditory canal wall, fit into grooves drilled in tegmen and tympanomastoid suture bone, and overlaid with bone pâté, fascia graft, and skin elevated as a bipedicled visor flap from the floor of the mastoid bowl. The middle ear is reconstructed as required with homograft tympanic membrane and attached malleus (as shown) or temporalis fascia graft, with an ossicular chain reconstruction prosthesis. D, Lateral view of the reconstruction (pinna not shown). Facial n indicates facial nerve; FP, foot plate of the stapes; and RW, round window. Figure Legend:

2. Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Ceravital Reconstruction of Canal Wall Down Mastoidectomy: Long-term Results Arch Otolaryngol Head Neck Surg. 2006;132(6):617-623. doi:10.1001/archotol.132.6.617 Coronal computed tomographic scan acquired in a patient (patient 11) 14 years after the initial Ceravital (Ernst Leitz, Wetzlar, Germany; Xomed, Jacksonville, Fla) reconstruction of the right ear. The prosthetic wall (arrows) is intact, and the mastoid cavity (M) and middle ear (m) are well aerated. A total ossicular reconstruction prosthesis (double arrowhead) is present. Figure Legend:

3. Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Ceravital Reconstruction of Canal Wall Down Mastoidectomy: Long-term Results Arch Otolaryngol Head Neck Surg. 2006;132(6):617-623. doi:10.1001/archotol.132.6.617 Intraoperative view of the right mastoid cavity and middle ear of patient 11 during revision ossiculoplasty, shortly after the computed tomographic scan in Figure 2. The Ceravital (Ernst Leitz, Wetzlar, Germany; Xomed, Jacksonville, Fla) canal wall reconstruction (arrows) was firmly integrated with adjoining bone. Prior to elevation, overlying ear canal skin (asterisk) adhered to the prosthetic canal wall as it would to native bone. The mastoid (M) and middle ear (m) are well aerated. A total ossicular reconstruction prosthesis (double arrow) was placed. Crossed arrows denote orientation; A indicates anterior; S, superior. Figure Legend: