Preparation and placement of cartilage island graft in tympanoplasty

Yurttaş, Veysel; Yakut, Fatih; Kutluhan, Ahmet; Bozdemir, Kazım

doi:10.1016/j.bjorl.2014.08.007

Cited by 16 publications

(12 citation statements)

References 22 publications

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“…Therefore, cartilage graft materials are preferred for large perforations. 13 Kazikdas et al found 95.7% graft success rate for palisade cartilage graft, compared with 75% for temporalis fascia grafts. 14 …”

Section: Discussionmentioning

confidence: 98%

Impact of cartilage graft size on success of tympanoplasty

Abdelhameed

Rezk

Awad

2017

Brazilian Journal of Otorhinolaryngology

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Section: Discussionmentioning

confidence: 98%

Impact of cartilage graft size on success of tympanoplasty

Abdelhameed

Rezk

Awad

2017

Brazilian Journal of Otorhinolaryngology

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“…It receives its nutrients by diffusion and perichondrial attachment on one side increases its 16 The main advantage of cartilage tympanoplasty is that epithelisation may continue over the cartilage surface even if the graft detaches anteriorly. 17 The other advantage is that cartilage tympanoplasty avoids synechia formation between the graft and promontory, because there is no need to use absorbable gelatin sponge in the middle ear to support the graft. 17 Therefore, cartilage has now become the preferred graft material over temporalis fascia in high risk perforations.…”

Section: Discussionmentioning

confidence: 99%

“…17 The other advantage is that cartilage tympanoplasty avoids synechia formation between the graft and promontory, because there is no need to use absorbable gelatin sponge in the middle ear to support the graft. 17 Therefore, cartilage has now become the preferred graft material over temporalis fascia in high risk perforations. Cartilage graft was first described Heerman in 1962.…”

Section: Discussionmentioning

confidence: 99%

All Cartilage No Stitch Type 1 Tympanoplasty – A Prospective Study

Chakraborty

Das

Chatterjee³

et al. 2018

BJOHNS

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Introduction Although temporalis fascia is the commonly used graft material for tympanoplasty, cartilage has become the material of choice in cases with eustachian tube dysfunction, bilateral disease, total or anterior perforation of tympanic membrane, tympanosclerosis etc. Cartilage slices < 0.5 mm thick are similar to the tympanic membrane in their acoustic properties. The present study is aimed to describe stitch-less type 1 tympanoplasty with sliced tragal cartilage-perichondrium and evaluate anatomical, audiological and cosmetic outcomes. Materials and Methods A prospective study was conducted from March 2014 to August 2016, in ENT department of a Government Medical College and Hospital, West Bengal, India. Primary tympanoplasty cases irrespective of age, size and site of perforation, laterality and eustachian tube function were included in the study. History of previous tympanoplasty or mastoid surgery and cases requiring ossicular reconstruction or mastoidectomy were excluded from the study. Sliced tragal cartilage-perichondrium graft of 0.2 mm thickness was placed in underlay fashion through trans-canal or end-aural route. Results Among 95 cases 38 were male, 57 were female with age range between 7 to 68 years. Average operative time was 30 minutes. Graft take was successful in 97.89% of cases. Average Air Bone Gap 12 months after operation was 13.03dB. Conclusion Sliced cartilage-perichondrium graft gives good balance between sufficient stability and adequate acoustic sensitivity. Moreover, no stitch technique reduces operative time and increases cosmesis.

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“…Causes of tympanoplasty failure using a temporal muscle fascia graft included severe ear pathologies, pathology of the malleus handle and stapes arch revision surgery, atelectasis, cholesteatoma, tympanosclerosis, large (>50% of total tympanic membrane diameter) and anterior perforations, tobacco smoke exposure, perforation drainage during surgery, and bilateral disease. 12 All the patients underwent revision tympanoplasty with cartilage-perichondrium composite island graft, done using underlay technique after slicing the cartilage with help of cartilage slicer. Ossiculoplasty was performed as and when needed.…”

Section: Discussionmentioning

confidence: 99%

Is cartilage- perichondrium composite graft tympanoplasty the ideal treatment for revision tympanoplasty

Tyagi¹,

Tyagi²,

Srivastava³

et al. 2016

Int J Otorhinolaryngol Head Neck Surg

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INTRODUCTIONTympanoplasty has undergone tremendous evolution since it was first described by by Wullstein in 1952 andZoellner in 1955. 1,2 Over the decades various autologus (temporalis fascia, fascia lata, periosteum, perichondrium, cartilage with or without peri-chondrium, veins, fatty tissue, and skin) and homologus (dura mater, pericardium, cartilage, amniotic membrane, skin, cornea, peritoneum, veins, and aortic valve) grafting materials and techniques were used in tympanoplasty operations.3 Temporalis fascia remains the most commonly used material for tympanic membrane reconstruction, with a success rate of 93% to 97% in primary tympanoplasties. 4 In high risk situations such as the subtotal perforation, atelectatic ear, cholestetoma, and revision tympanoplasty, the results have not been found to be commendable. In these situations, fascia and perichondrium have shown to undergo atrophy and subsequent failure in post-operative period.5 Heerman claimed to have used the cartilage palisade technique for middle ear and mastoid cavity reconstruction since 1960, in over 13,000 cases. Reconstruction of tympanic membrane with cartilage counteracts the tendency to retraction of soft autologus materials like temporalis fascia or perichondrium. Because of its low turn-over rate, cartilage is more resistant to infection. 6 METHODS55 patients who underwent revision tympanoplasty were taken from the department of Otorhinolaryngology, Harsh ENT Hospital, Ghaziabad. Data were collected from the record section and analysed in various aspects. A retrospective chart review was performed of all patients who underwent cartilage composite graft revision tympanoplasty. All the cases were thoroughly examined and investigated before taking them for surgery, findings ABSTRACT Background: The objective of the study was to evaluate the anatomical and audiological outcomes of cartilageperichondrium composite graft tympanoplasty by underlay technique in revision tympanoplasties. Methods: A series of 55 patients who underwent revision tympanoplasty with cartilage-perichondrium composite Island graft, at the department of Otorhinolaryngology, Harsh ENT Hospital, Ghaziabad. Tympanoplasty with cartilage-perichondrium composite island graft was done using underlay technique after slicing the cartilage with help of slicer. Ossiculoplasty was performed as and when needed. Results: Graft uptake rate was found to be 96.36% (53 of the 55 cases) in our study without any serious complications. Audiological outcomes with closure of 94.55% air bone gap within 0 to 30 dB was achieved (p <0.05). Conclusions: Nearly 97% success rate can be achieved with cartilage-perichondrium composite graft tympanoplasty for Revision tympanoplasty.

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Preparation and placement of cartilage island graft in tympanoplasty

Abstract: If cartilage graft is properly prepared and placed, cartilage graft tympanoplasty appears to provide better success rates and hearing results.

Cited by 16 publications

References 22 publications

Impact of cartilage graft size on success of tympanoplasty

Impact of cartilage graft size on success of tympanoplasty

All Cartilage No Stitch Type 1 Tympanoplasty – A Prospective Study

Is cartilage- perichondrium composite graft tympanoplasty the ideal treatment for revision tympanoplasty

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