Anatomic and functional results in tragal cartilage tympanoplasty in adults: Correlation with prognostic factors

Abstract

Objectives: This study aims to evaluate the graft success and functional results of cartilage island graft tympanoplasties performed in adult patients. Patients and Methods:Medical records of patients operated on for chronic otitis media at our clinic were reviewed. One hundred and ninety-five patients (212 ears) older than 16 years of age that had undergone tympanoplasty operation and that had been followed up for at least six months postoperatively, were included in the study. The prognostic factors that could have impact on graft success were analyzed. The pure-tone average and postoperative gain in air-bone gap (ABG) were recorded as the mean of 0.5, 1 and 2 kHz thresholds.Results: Graft success was achieved in 191 patients (90%), and graft perforation occurred in 21 patients (10%). When the risk factors that might lead to graft perforation were analyzed separately, the presence of cholesteatoma (p=0.014), and not performing mastoidectomy during tympanoplasty (p=0.031) were significantly associated with graft perforation. The average preoperative ABG, including all types of tympanoplasty operations was 40.20±17.3 dB, and postoperative ABG was 30.14±19.21 dB (p<0.05). Conclusion:The presence of cholesteatoma and tympanoplasty without mastoidectomy were found to affect graft success negatively. Cartilage island graft is an effective technique for tympanic membrane closure and significant hearing improvement.

Comparison the Anatomical Success of Fascia Versus Cartilage Graft in Myringoplasty Cases with Contralateral Perforation

“…10 Tragal kartilaj timpanoplasti uygulanmış 212 kulağın değerlendirildiği bir diğer çalışmada ise karşı kulakta perforasyon varlığının ve gerçekleştirilen cerrahi yöntemin greft başarısı üzerine bir etkisinin bulunmadığı belirtilmiştir. 11 Uygulanan cerrahi yöntemin primer miringoplastide temporal fasiya greft başarısı üzerine etkisi araştırılmış, genel başarı %95, retroauriküler yaklaşım %97, endaural ve transkanal yaklaşım da %77 olarak hesaplanmıştır. 4 Retroauriküler yaklaşımla birlikte, underlay greft yerleştirme tekniğinin kullanılmasının en iyi postoperatif sonuçları verdiği bildirilmiştir.…”