Clinical advantages of cartilage palisades over temporalis fascia in type I tympanoplasty

Vashishth, Ashish; Mathur, N. N.; Choudhary, Santosha Ram; Bhardwaj, Abhishek

doi:10.1016/j.anl.2014.05.015

Cited by 37 publications

(27 citation statements)

References 15 publications

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“…Kazikdas et al [12], Sishegar et al [15] and Demirpehlivan et al [16] only included subtotal perforations, with the defect being described as more than 50% of the area of the whole tympanic membrane. Vashishth et al [17] selected patients for fascia or palisade group based on various risk factors. Specifically, the authors excluded patients with craniofacial abnormalities, revision tympanoplasties, near-total/total perforations, and persistently discharging ears from the fascia group.…”

Section: Resultsmentioning

confidence: 99%

“…To our knowledge, only one study to date specifically examined the use of cartilage palisades in the pediatric population. Vashishth et al examined outcomes of cartilage palisades over temporalis fascia at 6 months and 1 year in children and adult patients [17]. Although the authors demonstrated excellent results in the palisade group, we were unable to extract data for subgroup analysis (i.e.…”

Section: Discussionmentioning

confidence: 99%

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The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis

Jeffery

Shillington

Andrews

et al. 2017

J of Otolaryngol - Head & Neck Surg

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BackgroundTympanoplasty is a common procedure performed by Otolaryngologists. Many types of autologous grafts have been used with variations of techniques with varying results. This is the first systematic review of the literature and meta-analysis with the aim to evaluate the effectiveness of one of the techniques which is gaining popularity, the palisade cartilage tympanoplasty. PubMed, EMBASE, and Cochrane databases were searched for "palisade", “cartilage”, “tympanoplasty”, "perforation" and their synonyms.Main body of abstractIn total, 199 articles reporting results of palisade cartilage tympanoplasty were identified. Five articles satisfied the following inclusion criteria: adult patients, minimum 6 months follow-up, hearing and surgical outcomes reported. Studies with patients undergoing combined mastoidectomy, ossicular chain reconstruction, and/or other middle ear surgery were excluded. Perforation closure, rate of complications, and post-operative pure-tone average change were extracted for pooled analysis. Study failure and complication proportions that were used to generate odds ratios were pooled. Fixed effects and random effects weightings were generated. The resulting pooled odds ratios are reported. Palisade cartilage tympanoplasty has an overall take rate of 96% at beyond 6 months and has similar odds of complications compared to temporalis fascia (OR 0.89, 95% CI 0.62, 1.30). The air-bone gap closure is statistically similar to reported results from temporalis fascia tympanoplasty.ConclusionsCartilage palisade tympanoplasty offers excellent graft take rates and good postoperative hearing outcomes for perforations of various sizes and for both primary and revision cases. This technique has predictable, long-term results with low complication rates, similar to temporalis fascia tympanoplasty.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis

Jeffery

Shillington

Andrews

et al. 2017

J of Otolaryngol - Head & Neck Surg

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“…However, recent studies have reported that cartilage grafts prepared and applied appropriately have similar results of hearing gain to the fascia grafts with more successful graft retention rates. [5][6][7][8] Fascia grafts are always harvested from the temporal muscle, regardless of the endaural or postauricular approaches. Cartilage grafts are harvested from the tragal or conchal area, depending on the location of the incision.…”

Section: Discussionmentioning

confidence: 99%

A comparison between fascia and cartilage graft tympanoplasty techniques in broad tympanic membrane perforations

Aydemir¹

2019

KBB Uygulamaları

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Amaç: Bu çalışmada subtotal timpanik membran perforasyonlu hastalarda, temporal kas fasya ve kıkırdak greftli timpanoplasti sonuçları karşılaştırıldı. Hastalar ve Yöntemler:Ekim 2011-Nisan 2013 tarihleri arasında, inaktif kronik otitis media nedeniyle timpanoplasti yapılan ve subtotal timpanik membran perforasyonu olan toplam 67 hasta (42 kadın, 25 erkek; ort. yaş 30.1 yıl; dağılım 12-49 yıl) çalışmaya alındı. Hastalar kıkırdak greft grubu (CGG, n=33) ve fasya greft grubu (FGG, n=34) olmak üzere rastgele iki gruba ayrıldı. Ortalama hava eşiği ve ortalama hava-kemik aralığı (ABG) 500, 1000 ve 2000 Hz'de saf ton odyometrisi ile ölçüldü. Başarılı greftleme oranları ve işitme sonuçları gruplar arasında karşılaştırıldı.Bulgular: Takip süresi 12 ay idi. Ameliyat öncesi ortalama saf ton işitme eşiği (PTHT) CGG ve FGG'de sırasıyla 48.9 dB ve 45.88 dB idi. Ameliyat öncesi ortalama ABG, CGG ve FGG'de sırasıyla 29.03 dB ve 30.94 dB idi. Ameliyat sonrası ortalama saf ton işitme kazanımı CGG ve FGG'de sırasıyla 8.96 dB ve 10.5 dB idi. Ameliyat sonrası ortalama ABG, CGG ve FGG'de sırasıyla 6.45 dB ve 9.11 dB idi. Havakemik aralığı ve saf ton ortalama skorları açısından iki grup arasında anlamlı bir fark yoktu (p=0.51-0.155). Başarılı greftleme oranı CGG ve FGG'de sırasıyla %96.9 (32/33) ve %82.3 (28/34) idi.Sonuç: Geniş timpanik membran perforasyonlarında başarılı greftleme oranı FGG'ye kıyasla CGG ile daha yüksek olmakla birlikte, her iki tekniğin işitme sonuçları benzerdir.Anahtar sözcükler: Kronik otitis media, kıkırdak palisad timpanoplastisi, temporal fasya. ABSTR ACTObjectives: This study aims to compare the results of temporal muscle fascia and cartilage graft tympanoplasty operations in patients with subtotal tympanic membrane perforations. Patients and Methods:Between October 2011 and April 2013, a total of 67 patients (42 females, 25 males; mean age 30.1 years; range, 12 to 49 years) who underwent tympanoplasty due to inactive chronic otitis media and who had subtotal tympanic membrane perforation were included in this study. The patients were randomly divided into two groups as the cartilage graft group (CGG, n=33) and the fascia graft group (FGG, n=34). The mean air thresholds and mean air-bone gap (ABG) at 500, 1,000, and 2,000 Hz were measured by pure tone audiometry. Successful engraftment ratios and hearing outcomes were compared between the groups. Results:The duration of follow-up was 12 months. The mean preoperative pure tone hearing threshold (PTHT) in CGG and FGG were 48.9 dB and 45.88 dB, respectively. The mean preoperative ABG in CGG and FGG were 29.03 dB and 30.94 dB, respectively. The mean postoperative pure tone hearing gain in CGG and FGG were 8.96 dB and 10.5 dB, respectively. The mean postoperative ABG in CGG and FGG were 6.45 dB and 9.11 dB, respectively. There was no significant difference between the two techniques in terms of the ABG and pure tone average scores (p=0.51-0.155). Successful engraftment ratio in CGG and FGG were 96.9% (32/33) and 82.3% (28/34), respectively. Conclusion:Although su...

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“…Although better hearing outcomes have been documented in type III tympanoplasty using synthetic ossicular grafts as demonstrated in various past literatures, a substantial proportion of the patients require revision surgery because of displacement and extrusion of graft in the postoperative period [5][6][7]. There are very few studies conducted in the past showing cartilage being exclusively used for ossiculoplasty and tympanic membrane grafting (classical type III tympanoplasty) in canal wall down mastoidectomy [8] although it has been widely used for type I cartilage tympanoplasty for the reconstruction of a large central perforation and for the repair of attic defect in limited attic disease [9][10][11][12]. A similar study conducted by Quaranta et al [13] taking patients undergoing cartilage tympanoplasty in intact canal wall mastoidectomy has demonstrated 100% anatomical closure of tympanic membrane without any extrusion of cartilage graft in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Cartilage Palisade Grafting in Retrograde Canal Wall Down Mastoidectomy: A Review of 80 Cases

Pradhan¹,

Lal²

2017

Otolaryngol (Sunnyvale)

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Objective: Although synthetic grafts have been extensively used for tympanoplasty in canal wall down mastoidectomy, a substantial proportion of the patients show graft extrusion. Conchal cartilage grafts can be effectively used for the above purpose for a better graft uptake and hearing gain. Here, anatomical and functional outcomes have been assessed in 80 patients undergoing retrograde canal wall mastoidectomy with cartilage tympanoplasty. Material and methods:This study was conducted in a tertiary care referral hospital during the period from July 2012 to June 2015. A total 80 patients of active squamous disease with conductive hearing had undergone canal wall down mastoidectomy. Pure tone audiogram and speech reception thresholds were carried out in preoperative and each postoperative visit i.e. at 3, 6, 12 months of surgery. ≥ 10 dB closure of air-bone (AB) gap and ≥ 10 dB improvement in speech reception threshold were considered significant. Results:Out of 80 patients, 58 (72.50%) were males and 22 (27.50%) were females and 68 (85.00%) were fresh cases and 12 (15.00%) were revision cases. Overall closure of the tympanic membrane was achieved in 76 (95.00%) cases. At the end of 12 months, mean air conduction threshold was 34.30 dB with 8.2 dB closures of AB gap was found in new cases and 35.08% of them had significant improvement in hearing. Again the mean air conduction thresholds for the revision cases was 40.8 dB with 6.9 dB closure of AB gaps noticed at the end of 12 months and 25% of the them had significant improvement in hearing (≥ 10 dB closure). Conclusion:Autologous conchal cartilage can be used for the tympanic membrane grafting in patients undergoing canal wall down mastoidectomy with minimal rejection rate. Although significant improvement in hearing was achieved in 33.80% cases, almost all had social serviceable hearing till the end of 12 months.

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Clinical advantages of cartilage palisades over temporalis fascia in type I tympanoplasty

Cited by 37 publications

References 15 publications

The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis

The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis

A comparison between fascia and cartilage graft tympanoplasty techniques in broad tympanic membrane perforations

Cartilage Palisade Grafting in Retrograde Canal Wall Down Mastoidectomy: A Review of 80 Cases

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