Does cartilage tympanoplasty impair hearing in patients with normal preoperative hearing? A comparison of different techniques

Balci, Mustafa; İşlek, Akif; Ciğer, Ejder

doi:10.1007/s00405-018-5262-3

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…They also reported a higher graft acceptance rate in cartilage group. 11 Ciğer et al compared these 2 graft materials in their prospective, randomized study and they found similar hearing outcomes in both techniques. Graft success rate at the first year was 85.1% in the fascia group and 97.7% in the cartilage group and this difference was statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Temporalis Fascia and Transcanal Composite Chondroperichondrial Tympanoplasty Techniques

Gözeler

Şahin

2019

Ear Nose Throat J

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The purpose of this study was to compare the success rates and hearing outcomes of transcanal composite chondroperichondrial cartilage graft with that of underlay temporal muscle fascia (TMF) graft for myringoplasty. In this retrospective study, the medical records of patients who underwent type 1 myringoplasty between September 2015 and February 2018 at Otorhinolaryngology Department of Erzurum Ataturk University were reviewed. Demographic properties, preoperative otological findings, preoperative pure ton audiogram findings, postoperative pure ton audiogram findings, and duration of surgeries were reviewed from medical records. The patients with lack of one or more of these information at medical records or lost to at least 3 months of follow-up were excluded from the study. According to the graft material used in the operation, the patients were divided into 2 groups. The patients operated with cartilage graft by transcanal composite chondropericondrial cartilage graft myringoplasty (TCM) technique was regarded as first group, while patients operated with temporal fascia was regarded as the second group (TMF). Both groups were compared according to preoperative and postoperative air–bone gap (ABG), graft acceptance rate, and duration of operation using SPSS version 20.0 software. A total of 113 patients whose medical records met the inclusion criteria were included in the study. Of these, 59 underwent TCM and 54 underwent TMF myringoplasty. Tympanic membrane perforation closure success rate was higher in the cartilage group (94.9%) than in the fascia group (83.3%; P = .046). In the former, preoperative and postoperative ABG was 19.5 ± 5 and 10.8 ± 4.8 dB, respectively. In the latter, the corresponding values were 20.7 ± 5.4 and 11.5 ± 5.4 dB, respectively ( P < .05). Duration of surgery was 29.5 ± 3.4 minutes in the TCM group and 61.5 ± 6.0 minutes in the TMF group ( P < .05). Transcanal cartilage myringoplasty could be considered as an appropriate surgical option because of its simplicity, shorter operation time, and rapid patient recovery, with no significant difference in terms of hearing outcomes compared to temporal fascia.

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Section: Discussionmentioning

confidence: 99%

Comparison of Temporalis Fascia and Transcanal Composite Chondroperichondrial Tympanoplasty Techniques

Gözeler

Şahin

2019

Ear Nose Throat J

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“…Similar results of no significant postoperative hearing difference were reported between fascia and perichondrium [ 6 ]. Although cartilage tympanoplasty might show a worse air-bone gap closure at high frequencies due to the graft’s stiffness or mass effect [ 4 ], several studies had reported comparable hearing outcomes between fascia and cartilage [ 30 – 33 ].…”

Section: Discussionmentioning

confidence: 99%

Shifting from postauricular to transcanal microscopic tympanoplasty may have similar frequency-specific improvements with better air-bone-gap closure at low frequencies and a minimal learning-curve effect

Huang

Chuang

et al. 2021

PLoS ONE

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The shift from postauricular to transcanal microscopic tympanoplasty brings potential advantages of minimal morbidity, less postoperative pain, patient comfort, and surgical ease and speed, but also uncertainties of unfamiliar grafting material, an inadequate operation view, and an uncertain learning curve. These challenges might affect the successful repair rate and the frequency-specific hearing outcome, which is important for hearing perception. Rare studies reported frequency-specific hearing outcome with the learning curve for shifting from postauricular to transcanal microscopic tympanoplasty. Here, from Jul. 2013 to Nov. 2018, we compared patients in a shift from postauricular approach (35 ears) to transcanal approach (35 ears) of microscopic type-1 tympanoplasty. The results show that both of postauricular and transcanal microscopic tympanoplasties reduced the mean air-bone gap, 0.5k Hz gap, and 1k Hz gap after the surgery. The further analyses on gap change as a function of frequency (0.5, 1, 2, and 4k Hz) show that both of postauricular and transcanal tympanoplasties improved postoperative air-bone gap among the levels of frequency. The post hoc comparisons display a common gap reduction difference between 0.5k and 4k Hz. The successful repair rate did not differ between the 2 groups. There was no correlation between the postoperative mean gap change and the surgery date, suggesting a minimal learning-curve effect. The results of similar frequency-specific improvements and a minimal learning-curve effect may help to ease the concerns of those uncertainties before the shift.

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“…1 Various techniques of cartilage tympanoplasty have been proposed. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] We use an over-under technique, where the cartilage-perichondrial island graft is placed lateral to the malleus and medial to the annulus. We also use a cartilage shim between the native tympanic membrane and the cartilage graft when the graft does not make contact with the tympanic membrane, and we believe this additional step is unique.…”

Section: Introductionmentioning

confidence: 99%

“…We have found overunder cartilage tympanoplasty to be a flexible and versatile approach in addressing the tympanic membrane, but the available articles on this only briefly describe the approach. [2][3][4][5][6][10][11][12][13][14][15] The objectives of this article are to describe the technique we use for the microscopic over-under cartilage tympanoplasty and to report the hearing outcomes and complications. We hypothesised that hearing would be shown to improve across the hearing spectrum and that reperforation would be rare.…”

Section: Introductionmentioning

confidence: 99%

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Over-under cartilage tympanoplasty: technique, results and a call for improved reporting

et al. 2020

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Objective This study aimed to describe the microscopic over-under cartilage tympanoplasty technique, provide hearing results and detail clinically significant complications. Method This was a retrospective case series chart review study of over-under cartilage tympanoplasty procedures performed by the senior author between January 2015 and January 2019 at three tertiary care centres. Cases were excluded for previous or intra-operative cholesteatoma, if a mastoidectomy was performed during the procedure or if ossiculoplasty was performed. Hearing results and complications were obtained. Results Sixty-eight tympanoplasty procedures met the inclusion criteria. The median age was 13 years (range, 3–71 years). The mean improvement in pure tone average was 6 dB (95 per cent confidence interval 4–9 dB; p < 0.0001). The overall perforation closure rate was 97 per cent (n = 66). Revision surgery was recommended for a total of 6 cases (9 per cent) including 2 post-operative perforations, 1 case of middle-ear cholesteatoma and 3 cases of external auditory canal scarring. Conclusion Over-under cartilage tympanoplasty is effective at improving clinically meaningful hearing with a low rate of post-operative complications.

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Does cartilage tympanoplasty impair hearing in patients with normal preoperative hearing? A comparison of different techniques

Cited by 7 publications

References 12 publications

Comparison of Temporalis Fascia and Transcanal Composite Chondroperichondrial Tympanoplasty Techniques

Comparison of Temporalis Fascia and Transcanal Composite Chondroperichondrial Tympanoplasty Techniques

Shifting from postauricular to transcanal microscopic tympanoplasty may have similar frequency-specific improvements with better air-bone-gap closure at low frequencies and a minimal learning-curve effect

Over-under cartilage tympanoplasty: technique, results and a call for improved reporting

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