Cartilage Plate Tympanoplasty

Beutner, Dirk; Hüttenbrink, Karl-Bernd; Stumpf, Robert; Beleites, Thomas; Zahnert, Thomas; Lüers, Jan-Christoffer; Helmstaedter, Victor

doi:10.1097/mao.0b013e3181be6b48

Cited by 36 publications

(30 citation statements)

References 29 publications

(30 reference statements)

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“…The marginally larger diameter of the punched cartilage shoe (2.5 × 3.5 mm), as compared to the stapes footplate, is a prerequisite for a secure and tight grip between the bony promontory and facial canal wall and prevents dislocation of the cartilage grafts placed. The inserted prosthesis is always covered by cartilage plates of the reconstructed tympanic membrane,2 which holds the prosthesis foot in contact with the footplate.…”

Section: Surgical Proceduresmentioning

confidence: 99%

The sandwich cartilage shoe technique for ossicular reconstruction in a case of an unsecure stapes footplate

2011

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This article describes a new surgical method for total ossicular reconstruction in a case of a broken stapes footplate. We developed the technique of the "cartilage shoe sandwich," which consists of two surgical steps. First, the closure of the oval window is achieved by a cartilage shoe without a central perforation. During this surgical intervention, the prearrangement of a secure placement of a total ossicular replacement prosthesis is provided by a second cartilage with a central hole that is plugged with silicone. In a staged procedure, the silicone plug is removed and the ossicular reconstruction can be performed. The audiological results of the first patients show a stable inner ear function with an air-conduction gain of 9 dB. The technique described herein has proven to be safe and reliable in total ossicular reconstruction in the event of an unsecure stapes footplate.

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Section: Surgical Proceduresmentioning

confidence: 99%

The sandwich cartilage shoe technique for ossicular reconstruction in a case of an unsecure stapes footplate

2011

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“…Unlike solid structures like bone or alloplastic prostheses, cartilage and any softer materials will absorb part of the acoustic energy and hence negatively impact the sound transmission as compared with the osseous footplate (6). Even in the long-run, the chance for improvement is unlikely, administered the fact that cartilage will soften over the time (5). From an acoustic point of view, the construction of neo-footplate from cartilage only cannot be considered optimal.…”

Section: Discussionmentioning

confidence: 98%

“…Thereafter, a TORP prosthesis (length 3.0-5.0 mm) (Kurz) was inserted, resting with its foot on either the head of the Omega Connector (n ¼ 3) or on the lower cartilage shoe (n ¼ 9), stabilized by the upper perforated cartilage shoe. The plate of the TORP was placed underneath the cartilage-reconstructed tympanic membrane (5).…”

Section: Surgerymentioning

confidence: 99%

Long-term Follow-up Study of the Sandwich Cartilage Shoe Technique in Cases of Insecure Stapes Footplate

Lüers

Schwarz

Anagiotos

et al. 2016

Otology &Amp; Neurotology

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The sandwich cartilage shoe technique offers a safe and effective option as a two-stage procedure in treating patients with fractures of the stapes footplate in case of chronic otitis media. In view of the possible risk of deafness going along with a destruction of an inner ear window, our results can be considered substantial as all our patients will at least be able to regain "social hearing" as they all either achieved a hearing threshold is less than 30 dB or can be sufficiently supplied with a conventional hearing aid.

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“…However, perichondrium attached to a thin slice of cartilage can lead to unacceptable curling and can offset the assembly. Furthermore, a rate of 50 % re-retraction has been documented by some authors while using half thickness cartilage in patients with Eustachian tube dysfunction [19]. In the present study, we used full thickness cartilage with attached perichondrium (facing the ear canal side) for better resistance to retraction and encountered no problems with curling.…”

Section: Comparison With Other Studiesmentioning

confidence: 89%

Cartilage Palisades in Type 3 Tympanoplasty: Functional and Hearing Results

Vashishth

Mathur

Verma

2014

Indian J Otolaryngol Head Neck Surg

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To evaluate the functional and hearing outcomes using full thickness broad cartilage palisades for tympanic membrane reconstruction in type 3 tympanoplasty with titanium prostheses. The retrospective study performed at a tertiary referral institute included 30 patients with posterior mesotympanic retraction pockets or tympanic membrane perforations requiring tympanic membrane and type 3 ossicular reconstruction. Patients with disease extending beyond the aditus requiring canal wall down mastoidectomy were excluded. Disease removal from posterior mesotympanic and epitympanic recesses was confirmed using angled endoscopy and ossicular reconstruction was performed using titanium partial or total ossicular replacement prostheses. Tympanic membrane reconstruction was done, with or without attic reconstruction, using full thickness broad cartilage palisades harvested from the tragus with perichondrium attached laterally. Patients were assessed at 24 and 48 weeks for graft status and any evidence of implant extrusion. Hearing evaluation was done using subjective assessment and pure tone audiometry. In total, 27 out of 30 patients had intact and completely healed grafts at 48 weeks postoperatively (a success rate of 90 %) showing full union and epithelialization of palisades, and with three patients displaying small defects. The mean pure tone air bone gap pre-and postoperatively was 32.4 and 8.8 dB, respectively, with most patients reporting satisfactory postoperative hearing. No evidence of implant extrusion was found in the 48-week period. Tympanic membrane reconstruction using full thickness palisades of tragal cartilage provides good functional and hearing outcomes in type 3 tympanoplasty with titanium prostheses.

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Cartilage Plate Tympanoplasty

Cited by 36 publications

References 29 publications

The sandwich cartilage shoe technique for ossicular reconstruction in a case of an unsecure stapes footplate

The sandwich cartilage shoe technique for ossicular reconstruction in a case of an unsecure stapes footplate

Long-term Follow-up Study of the Sandwich Cartilage Shoe Technique in Cases of Insecure Stapes Footplate

Cartilage Palisades in Type 3 Tympanoplasty: Functional and Hearing Results

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