Composite Chondroperichondrial Clip Tympanoplasty: The Triple “C” Technique

Fernandes, Sylvester Valentine

doi:10.1067/mhn.2003.88

Cited by 26 publications

(5 citation statements)

References 19 publications

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“…Tos [14] classified cartilage techniques for tympanoplasties into 6 groups that can be categorized into 2 main techniques: the palisade technique and island graft technique. Fernandes [5] and Ahmed et al [15] introduced the “triple C” technique, which resulted in 100% and 91.3% graft success rates, respectively. Genc [16] described the perichondrium-preserved palisade island graft technique for tympanoplasty with a 93.61% success rate, while Larrosa et al [17] found no obvious difference in hearing or graft take results obtained with the palisade cartilage graft technique compared to the endoscopic chondroperichondrial graft technique.…”

Section: Discussionmentioning

confidence: 99%

“…Most surgical methods for repair of tympanic membrane (TM) perforation are associated with a success rate of over 90%. [5] Temporalis fascia and cartilage are the commonly used autografts for myringoplasty. In the last 20 years, various studies have demonstrated that stiffness of cartilage helps achieve better stability and long-term uptake than fascia, making it a better choice in some difficult situations, such as poor eustachian tube function, infection, anterior perforation, and revision surgeries.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic closure of tympanic membrane anterior perforation using a strip-type chondroperichondrial graft

Liang

Chen

et al. 2022

Medicine

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Myringoplasty is a surgical procedure to reconstruct tympanic perforation. However, repair of anterior perforations is still challenging. To analyze the anatomical and hearing outcomes of myringoplasty with a new technique of chondroperichondrial graft via endoscopy, 23 adult patients were retrospectively analyzed. All patients had anterior perforations of tympanic membranes that were repaired with a composite strip-type cartilage-perichondrium graft through a total endoscopic transcanal approach. The anatomical graft success rate at postoperative 1 month was 86.96% (20/23) and reached 100% at the 6-and 12-month follow-up. Compared to the preoperative air conduction threshold (44.7 ± 13.56 dB) and air-bone gap (ABG) (22.35 ± 6.54 dB), the postoperative air conduction threshold and ABG decreased to 33.52 ± 10.88 dB and 12.52 ± 3.94 dB, respectively (P < .0001). Twenty-two (95.65%) patients had an ABG below 20 dB postoperatively. The mean ABG improvement in our cohort was 9.83 ± 5.00 dB. The functional graft success rate was 95.65% (22/23). The convenience, reliability, time, and labor savings accrued from the approach described here make it a good choice for repair of anterior perforation of tympanic membrane.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endoscopic closure of tympanic membrane anterior perforation using a strip-type chondroperichondrial graft

Liang

Chen

et al. 2022

Medicine

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“…Tragal cartilage with perichondrium fulfills all the required qualities of an ideal graft material namely low rejection rate, sufficient quantity, good tensile strength, conductive properties similar to that of tympanic membrane and easy availability. Fernandes from Newcastle, Australia published the technique of composite chondroperichondrial clip tympanoplasty using the tragal cartilage 10 . Tragal cartilage is a fibroelastic cartilage and being composed of collagen type II is also similar nature of the tympanic membrane, temporal muscle fascia consists primarily of collagen type I. Collagen type II has higher tensile strength than other types.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Myringoplasty with Temporal Fascia and With Sliced Tragal Cartilage Graft-A Comparative Study

Mohammad Tasrif,

Imtiaz,

Rahman

et al. 2024

Med. Today

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Introduction: Myringoplasty is the surgical procedure to repair tympanic membrane perforations and thereby improving hearing, providing a dry ear, and reducing susceptibility to infections. Although there are many kinds of techniques and graft materials used, no methods have proven indisputably superior to the other. Therefore, to find out the outcome of myringoplasty using temporal fascia and sliced tragal cartilage in chronic inactive mucosal otitis media was set as an objective of the study. Materials and Methods: This cross-sectional observational study was conducted at the department of Otolaryngology & Head-Neck surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH) for six months from July 2018 to December 2018, after acceptance of the protocol and approval from IRB. Patients attending in the ShSMCH with complaints of chronic inactive mucosal otitis media were approached for inclusion of the study and final selection were done in according to the selection criteria. Ethical issues were ensured properly throughout the study period and inclusion was confirmed following signing written informed consent. All patients were randomly allocated into two groups where one group were received myringoplasty with temporalis fascia graft and another group received sliced tragal cartilage. Total 50 patients (25 patients in each group) were included, and they were subjected to details history taking, physical examination and necessary investigations. The researcher conducted all the interview and collected data were recorded into a case record form for each patient. Data analysis was done by SPSS 17. Results: Of total, 50 study population, mean age of the 32.30±10.93 SD (years) with 58% male and 42% females respectively. No significant age and gender difference is noted across the group (p>0.05). Patients having temporal fascia graft had significantly higher proportion of graft uptake in comparison to patients having sliced tragal graft (p<0.05). Both groups of the patient improve significantly in term of hearing after operation (p<0.05 in each group) but comparison in between groups showed that the improvement was significantly higher in temporal fascia graft group (p<0.001). Conclusion: Myringoplasty with temporal fascia graft could be a better option than sliced tragal cartilage graft in our population. However, further larger study with longer follow up is necessary to finalize the comment. Medicine Today 2023 Vol.36 (1): 50-54

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“…3 A variety of myringoplastic techniques have been described in the literature including: the underlay, overlay technique, the technique 'Gelfilm Sandwich,' 'Swinging Door' technique, 'C' technique, the double-swing technique, 'fascible stitching' technique, the anterior anchor technique, the 'spot welding' technique assisted by laser. [4][5][6][7][8][9] The "underlay" and the "overlay" technique are two of the most frequent methods to position the graft relative to the remains of the tympanic membrane and the tympanic annulus. 10 The former is widely used and can be done relatively easily since the graft is placed completely in the medium of the remaining drum (or annulus) and manubrium.…”

Section: Introductionmentioning

confidence: 99%

Compare the Outcomes of Underlay and Onlay Myringoplasty

Fawad Khan,

Manan Khan,

Achakzai

et al. 2021

PJMHS

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Objective: To determine the outcomes between underlay and onlay techniques underwent myringoplasty. Study Design: Quasi-experimental study. Place and Duration of Study: Department of ENT, Nowshera medical College/Qazi Hussain Ahmad Medical Complex, Nowshera from 1st July 2018 to 30th June 2020. Methodology: One hundred patients with age ranges 12-55 years were enrolled. Patients details demographics age, sex and body mass index were recorded after taking informed written consent. Patients suffered with tympanic membrane perforation related to chronic otitis media and/or trauma were included. They were divided into two groups, I and II. Group I had 50 patients and received underlay myringoplasty and group II had 50 patients underwent for onlay myringoplasty. Outcomes among both groups were assessed in terms of graft success rate. Complete follow-up among both groups was taken in duration of 4 months. Results: There were 35 (70%) males and 15 (30%) females in group I while in group II 30 (60%) males and 20 (40%) females. Mean age in group I was 24.15±8.41 years with mean BMI 25.17±6.53 kg/m2 and in group II mean age was 25.15±8.41 years with mean BMI 25.21±6.14 kg/m2. In group I graft success rate was 48 (96%) and in group II 45 (90%) graft success found. Medialization in group I was 2 (4%) and in group II was 4 (8%) and no any lateralization was found in both groups. Hearing was improved in group I, mean air bone gap closure was 9.8±6.45dB and in group II 11.8±4.54 dB. Conclusion: The underlay technique for myringoplasty was more effective in terms of graft success and hearing improvement. Overall success rate among both groups was 93% among both groups. Keywords: Underlay technique, Overlay technique, Myringoplasty

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Composite Chondroperichondrial Clip Tympanoplasty: The Triple “C” Technique

Abstract: The described technique provides an effective method of closing nonmarginal perforations of the tympanic membrane.

Cited by 26 publications

References 19 publications

Endoscopic closure of tympanic membrane anterior perforation using a strip-type chondroperichondrial graft

Endoscopic closure of tympanic membrane anterior perforation using a strip-type chondroperichondrial graft

Outcome of Myringoplasty with Temporal Fascia and With Sliced Tragal Cartilage Graft-A Comparative Study

Compare the Outcomes of Underlay and Onlay Myringoplasty

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