Cartilage reinforcement tympanoplasty: otological and audiological results

Abstract

Preoperatively, only one patient had a retraction pocket but not a perforation, 12 (20%) patients had perforation of < 25% of the total tympanic membrane diameter, 12 patients had perforation between 25% and 50% of the total membrane diameter, 18 patients had a perforation between 50% and 75% of total membrane diameter and 17 patients had a perforation of > 75% of the total membrane diameter. Postoperatively we achieved total closure of tympanic membrane perforations for 47 patients but the perforations of 13 patients remained in various sizes (7 patients had tympanic membrane perforation < 25% of the total membrane diameter, 3 between 25% and 50%, 2 between 50% and 75% and 1 patient had a perforation > 75% of the total membrane diameter). There was a statistically significant difference between percentages of preoperative perforation and postoperative perforations (p = 0.001). Only 1.7% of patients had no perforation preoperatively and this ratio increased to 78.3% postoperatively. Also, 30% of patients had a perforation between 50% and 75% of the total membrane diameter, 28.3% of the patients had a perforation > 75% of the total membrane diameter preoperatively and this ratio decreased to 3.3% and 1.7%, respectively. Concerning the audiological parameters, the difference between preoperative and postoperative hearing levels was statistically significant (p = 0.001).

Butterfly cartilage graft myringoplasty results

“…The procedure is more comfortable for the patient postoperatively for several reasons. Since neither a tympanomeatal flap nor a postauricular incision is required because drum preparation does not require the removal of tympanosclerotic plaques or additional exposure, postoperative patient comfort is improved and the patient can hear just after surgery (3,5,8). During the follow-up period, we recorded that no graft had lateralized and no retraction pocket occurred, postoperative patient hearing comfort is improved and no problems were detected with the tragal incision in any patient; however, in two patients, the graft displaced into the middle ear.…”

Audiological and otological outcome in Bi-island chondroperichondrial graft type I tympanoplasty

“…5 There are many described techniques for cartilage tympanoplasty such as cartilage butterfly inlay technique, cartilage palisade technique, perichondrium cartilage island technique, cartilage mosaic technique and cartilage reinforcement technique. 6 This grafting material is easy to harvest from the conchal bowl or tragus and is well tolerated in the middle ear. Cartilage material has been criticized because of concerns regarding hearing results and postoperative middle ear surveillance in cholesteatoma cases also is blamed for the increased complication risk if acute otitis media occurs later on.…”

Tympanoplasty with Island Cartilage or Temporalis Fascia: A Comparative Study

“…The graft take rates of the perichondrium-cartilage and fascia groups were 91.3 and 88.2%, respectively, with an overall gain of 12.3 dB for the cartilage-perichondrium group and 12.7 dB for the fascia group [10] . Highrisk perforations including total, subtotal, atelectatic perforations, those with cholesteatoma and revision cases can be treated efficiently with cartilage reinforcement tympanoplasty [11] . It was also suggested that palisade cartilage tympanoplasty is an effective technique for tympanic membrane closure and hearing improvement in atelectatic ears, and mastoidectomy does not change the anatomic or audiologic findings in these types of ears [12] .…”