Is Cartilage Tympanoplasty More Effective Than Fascia Tympanoplasty? A Systematic Review

Mohamad, Shwan; Khan, Imran; Hussain, S. S. M.

doi:10.1097/mao.0b013e318254fbc2

Cited by 118 publications

(113 citation statements)

References 13 publications

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“…Yet, many studies have shown that there is no difference in the use of cartilage or fascia in morphological or hearing aspects [3,5,6,23] . Even studies reporting better hearing results in tympanoplasty with cartilage are present [22] .…”

Section: Discussionmentioning

confidence: 99%

“…In conclusion, the use of cartilage in tympanoplasty has been known for many years; however, because of the doubt of the negative effect on sound conduction, it is not used [3,4,6] . Yet, many studies have shown that there is no difference in the use of cartilage or fascia in morphological or hearing aspects [3,5,6,23] .…”

Section: Discussionmentioning

confidence: 99%

“…In different literatures, the rate ranges between 75-98% [1][2][3]6] . Factors affecting the success rate of surgery are age, localization and size of perforation, the condition of middle ear mucosa, the function of the Eustachian tube, the type of graft used, and surgical experience [2,6,13] . All of the patients in our study were operated by the same surgeon, and the same graft kind and surgical technique were used in order to standardize these variables as much as possible.…”

Section: Discussionmentioning

confidence: 99%

“…Failure in tympanoplasty may be due to a variety of reasons, such as properties of the graft used, operation technique, or patient-related reasons [4,5] . It is reported that factors, like ear atelectasis, Eustachian tube dysfunction, tympanosclerosis, active suppuration, condition of middle ear mucosa, wide perforation, and revision myringoplasty, are the reasons for low success rates in the use of temporal fascia [3,6,7] .Temporal muscle fascia graft is of poor stability, because it contains connective fibrous tissue with irregular elastic fibers [7] . Otherwise, cartilage or composite cartilage grafts are more resistant to infections, middle ear pressure, and lack of capillary feed.…”

Section: Introductionmentioning

confidence: 99%

“…Otherwise, cartilage or composite cartilage grafts are more resistant to infections, middle ear pressure, and lack of capillary feed. Therefore, it can be preferred in revision tympanoplasty in which the risk of perforation or retraction is higher [4,5,6,8,9] .…”

Section: Introductionmentioning

confidence: 99%

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Factors Affecting Success and Results of Cartilage-Perichondrium Island Graft in Revision Tympanoplasty

Şahan¹,

Derin²,

Deveer³

et al. 2014

Int Adv Otol

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OBJECTIVE:The chance of complete postoperative healing of the tympanic membrane is relatively low due to poor blood supply of the graft in patients who undergo revision tympanoplasty. The aim of this study is to assess postoperative healing and the factors affecting closure of the tympanic membrane and hearing gain after revision tympanoplasty with cartilage-perichondrium island graft. MATERIALS and METHODS:This study was conducted as a retrospective review of charts of patients who underwent revision tympanoplasty with composite cartilage-perichondrium island graft at our clinic. Patients who underwent radical or modified radical mastoidectomy for the treatment of cholesteatoma and who had stapes fixation were excluded. All grafts were placed using over-under technique. Ossiculoplasty and mastoidectomy were performed as needed. Closure of the tympanic membrane and hearing thresholds were evaluated at the end of postoperative year 1. RESULTS:Thirty-three cases, 14 females and 19 males with mean age 37.5±12.7, were included in the study. Ossiculoplasty was performed in 8 cases, and mastoidectomy was added to tympanoplasty in 12 cases. Tympanic membrane was intact in 29 cases (87.4%) in the 12th postoperative month. Large perforation, adhesive tympanic membrane, and especially hypertrophic middle ear mucosa were found to have negative impact on success of graft (p<0.01). The success of graft in patients with mastoidectomy was lower than without mastoidectomy (p<0.001). Age (p=0.491), gender (p=0.567), surgical approach (p=0.378), and the number of operations (p=0.283) did not contribute to the success of the graft. Average improvement of postoperative air conduction hearing threshold was 13.2±5.5 dB, and average decrease in air bone gap was 11.7±5.5 dB. CONCLUSION:Postoperative closure rate of the tympanic membrane was high and audiologic improvement was satisfactory with cartilage-perichondrium island graft in revision tympanoplasty. Cartilage-perichondrium island graft may be preferred for reconstruction of the tympanic membrane because of its resistance to inflammation and poor feeding in revision tympanoplasty.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Factors Affecting Success and Results of Cartilage-Perichondrium Island Graft in Revision Tympanoplasty

Şahan¹,

Derin²,

Deveer³

et al. 2014

Int Adv Otol

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3D printing‐assistedcombinatorial approach for designing mechanically‐tunable and vascular supportive nanofibrous membranes to repair perforated eardrum

Liu

Huo

Zhang

et al. 2020

J of Applied Polymer Sci

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Perforation of eardrum or tympanic membrane (TM) is a common clinical condition, which occurs due to infection or injury of the eardrum, and could results in varying degrees of conductive hearing loss among all ages. In this study, the authors report the combinatorial approach of designing mechanically-tunable and vascular supportive nanofibrous membranes by 3D printing-assisted electrospinning (e-spin) using polycaprolactone (PCL) and gelatin with different mass ratios suitable to repair a perforated eardrum. The physicochemical, mechanical, and biological properties of the membranes were characterized. The results show that the membrane has nanofibrous morphology with fibers are of varying size (400-600 nm in diameter) depending on processing conditions. The wettability and mechanical properties of the membrane can be tuned by regulating the gelatin content. Moreover, a biomimetic repair strategy inspired by chicken eggshell membrane, often used in wound dressings, was also presented for study and results show that the suture retention strength of the fabricated membrane can meet clinical translational requirements to promote TM healing. The vascular cell responsiveness of PCL/gelatin nanofibrous membrane was evaluated using human umbilical vein endothelial cells (HUVECs) and the results showed satisfactory biocompatibility, vascular cell responsiveness, and cell proliferation. The findings of this study demonstrate that the combinatorically engineered PCL/gelatin nanofibrous membrane has great potential for repairing perforated eardrum.

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Fascia compared to one-piece composite cartilage-perichondrium grafting for tympanoplasty

Lyons

Vissers

et al. 2015

The Laryngoscope

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Is Cartilage Tympanoplasty More Effective Than Fascia Tympanoplasty? A Systematic Review

Abstract: Tympanoplasty using cartilage with or without perichondrium has better morphological outcome than tympanoplasty using temporalis fascia. However, there was no statistically significant difference in hearing outcomes between the 2 grafts.

Cited by 118 publications

References 13 publications

Factors Affecting Success and Results of Cartilage-Perichondrium Island Graft in Revision Tympanoplasty

Factors Affecting Success and Results of Cartilage-Perichondrium Island Graft in Revision Tympanoplasty

3D printing‐assistedcombinatorial approach for designing mechanically‐tunable and vascular supportive nanofibrous membranes to repair perforated eardrum

Fascia compared to one-piece composite cartilage-perichondrium grafting for tympanoplasty

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