The role of different types of grafts in tympanoplasty

Freitas, Marcos Rabelo de; Oliveira, Thiago Corrêa de

doi:10.1016/j.bjorl.2014.05.018

Cited by 16 publications

(16 citation statements)

References 7 publications

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“…Audiological outcomes reflect graft uptake. 31 Not surprisingly, the postoperative ABGs showed no difference amongst both groups. However, using ABG as a categorical variable, yielded results favouring endoscopy.…”

Section: Discussionmentioning

confidence: 84%

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Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive—A meta‐analysis

Pap

Tóth

Gede

et al. 2019

Clinical Otolaryngology

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Background Endoscopic type I tympanoplasty was originally introduced in the 1990s, and the extensive spread of this practice can be easily observed. The conventional technique performed involves the repair of a tympanic membrane perforation, and is defined as microscopic type I tympanoplasty. Objective of Review The aim of this study was the comparison of postoperative outcomes of both the endoscopic and the microscopic type I tympanoplasty. Type of Review We conducted a meta‐analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines. Search Strategy A systematic literature search was performed in the databases of PubMed, Embase, Cochrane Library, Clarivate Analytics‐Web of Science, ClinicalTrials.gov, World Health Organization Library, and Scopus by inserting, ‘myringoplasty OR (tympanoplasty AND perforation)’ into the search query. We applied only a ‘human’ filter. We excluded non‐English studies. Additional records were identified by checking the references of relevant studies. Evaluation Method Comparative studies were included in our analysis. We calculated the pooled odds ratio (OR) with 95% confidence interval (CI) for dichotomous outcomes and weighted mean difference (WMD) with a 95% CI for continuous outcomes. Additionally, we assessed the risk of bias and estimated the quality of evidence for each outcome. Results Our systematic search yielded 16 studies (involving 1179 interventions), eligible for analysis. The pooled graft uptake rate (OR: 1.21, CI: 0.82‐1.77; I2 = 0.0%), the postoperative hearing results (WMD = −1.13; 95% CI: −2.72‐0.45; I2 = 78.1%) and the operation time (WMD = −21.11; 95% CI: −42.60‐0.38; I2 = 99.3%), were all comparable amongst the two techniques. In contrast, the endoscopic type I tympanoplasty outperforms when regarding the pooled canaloplasty rate (OR = 7.96; 95% CI: 4.30‐14.76; I2 = 0.0%, P = 1.000) and features an increase in desirable cosmetic results (OR = 19.29; 95% CI: 11.37‐32.73; I2 = 0.0%, P = 0.839), when compared with the microscopic approach. Conclusions Based on our meta‐analysis, the surgical outcomes of endoscopic type I tympanoplasty in terms of graft uptake rate, postoperative hearing results and operation time were comparable to the microscopic type I tympanoplasty. In regards to cosmetics, an increase in desirable results was achieved in the endoscopic group, particularly the incidence of canaloplasty which proved to be significantly lower.

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Section: Discussionmentioning

confidence: 84%

“…Audiological outcomes reflect graft uptake . Not surprisingly, the postoperative ABGs showed no difference amongst both groups.…”

Section: Discussionmentioning

confidence: 89%

Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive—A meta‐analysis

Pap

Tóth

Gede

et al. 2019

Clinical Otolaryngology

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“…On the other hand, some authors argue that these characteristics of cartilage may adversely affect sound conduction. 8 9 …”

Section: Discussionmentioning

confidence: 99%

“…Again, these functional results are comparable with the results reported for other graft materials. 8 …”

Section: Discussionmentioning

confidence: 99%

Periosteal Graft Myringoplasty: Our Experience

El-Taher

Othman

Mohammed

et al. 2018

Int Arch Otorhinolaryngol

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Introduction Different types of autologous graft materials are used for myringoplasty, with the temporalis fascia and cartilage being the most frequently used tissues. Periosteal tissue has been used for a long time in our department, and many advantages support its use in myringoplasty. To the best of our knowledge, this issue is scarcely discussed in the previously published literature. Objective To present our experience with periosteal graft myringoplasty, describing the technique and the anatomical and functional outcomes. Methods A prospective clinical study involving 88 patients (72 females and 16 males) with a mean age 26.9 years. The patients underwent myringoplasty using the mastoid cortex periosteum; they were all operated using the postauricular approach, and the graft was applied using the underlay technique. The patients performed pre- and postoperative pure tone audiometry for tested frequencies (0.5 kHz, 1 kHz, 2 kHz, and 4 kHz). All patients were followed-up for at least 12 months after the operation. Results The anatomical success rate among all patients was of 93%, which is comparable to the rate of success in procedures using other usual grafting materials. In addition, there was a highly significant postoperative improvement in pure tone audiometry results as compared with the preoperative ones (the main hearing gain was of ∼ 11 dB; p < 0.001). Conclusion The periosteal graft is easily harvested, easy to apply, with excellent anatomical and functional success.

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“…As per available literature forcing Otologists to switch to other graft materials like Cartilage with better success rate but poor audiological outcome. 6,7,8 Various techniques have been used in failed cases of Tympanoplasty including office procedure using Trichloroacetic acid, 9 fat patching, 10 revision surgery using perichondrium or various other graft material with varying results. None of the technique used so far is a full proof method.…”

Section: Figure 1 Showing Various Stages Of Surgical Technique Pictomentioning

confidence: 99%

A Novel Technique to Salvage Failing Tympanoplasty- A Prospective Interventional Trial

Biswas¹,

Choudhary²,

Hazra³

et al. 2019

jemds

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BACKGROUND This article describes a procedure to salvage graft failures in cases of Tympanoplasty done using Temporalis Fascia by early intervention, Post operatively. METHODS It was an Observational study using 30 patients with residual perforations on 3 rd-6 th post-operative week out of 131 patients who underwent Type 1 Tympanoplasty with Cortical Mastoidectomy using Temporalis fascia as graft material. Study was conducted over a period of 18 months. Patients having residual perforation underwent the procedure after proper informed consent. 4 Quadrant blocks were given in External Auditory canal. The Epithelialized margin was freshened using a Micropick and medialised graft was repositioned after placing of a piece of Gelfoam in middle ear. The perforation was reinforced with a Gelfoam laterally in External Auditory Canal. Patient was then followed up with a course of Antibiotic and antihistaminic. RESULTS Out of 131 patients of cortical mastoidectomy with tympanoplasty 30 had residual perforation on follow up i.e., 77% success rate while 23% failure rate in our hand. These 23% patients, who were found to be failing, underwent this intervention. 24 out of these 30 patients (80%) i.e., 18% of overall cases showed healed drum after intervention on further follow up. Thus, a good number of failing Tympanoplasty could be salvaged and overall success achieved is almost 95% as compared to 77% previously.

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The role of different types of grafts in tympanoplasty

Cited by 16 publications

References 7 publications

Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive—A meta‐analysis

Endoscopic type I tympanoplasty is as effective as microscopic type I tympanoplasty but less invasive—A meta‐analysis

Periosteal Graft Myringoplasty: Our Experience

A Novel Technique to Salvage Failing Tympanoplasty- A Prospective Interventional Trial

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