Periosteal Graft Myringoplasty: Our Experience

Abstract

Introduction Different types of autologous graft materials are used for myringoplasty, with the temporalis fascia and cartilage being the most frequently used tissues. Periosteal tissue has been used for a long time in our department, and many advantages support its use in myringoplasty. To the best of our knowledge, this issue is scarcely discussed in the previously published literature. Objective To present our experience with periosteal graft myringoplasty, describing the technique and the anatomical and functional outcomes. Methods A prospective clinical study involving 88 patients (72 females and 16 males) with a mean age 26.9 years. The patients underwent myringoplasty using the mastoid cortex periosteum; they were all operated using the postauricular approach, and the graft was applied using the underlay technique. The patients performed pre- and postoperative pure tone audiometry for tested frequencies (0.5 kHz, 1 kHz, 2 kHz, and 4 kHz). All patients were followed-up for at least 12 months after the operation. Results The anatomical success rate among all patients was of 93%, which is comparable to the rate of success in procedures using other usual grafting materials. In addition, there was a highly significant postoperative improvement in pure tone audiometry results as compared with the preoperative ones (the main hearing gain was of ∼ 11 dB; p < 0.001). Conclusion The periosteal graft is easily harvested, easy to apply, with excellent anatomical and functional success.

Pediatric Myringoplasty using the Periosteum: An Institutional Overview

“…7,8,12 Proper selection of a suitable graft is crucial, especially in pediatrics, due to recurrent episodes of respiratory tract infection, which threaten surgical success. 9 Our results have shown an excellent graft uptake (95%), which are similar to those observed by ElTaher et al 7 (93%), Rao et al 8 (96%) Elmoursy and Elbahrawy 12 (95%), and ElBatawi et al 13 (93%). These results are also comparable to those found for other types of grafts, whether temporalis fascia or cartilage grafts.…”

“…8 To the best of our knowledge, the mentions of the use of the periosteum in pediatric CSOM in previous research are scarce. Some authors have reported 7,8,12 their experience with periosteal myringoplasty, but not in patients in a specific age group. In addition, most of their study samples were composed of adults.…”

“…In addition, most of their study samples were composed of adults. 7,8,12 Proper selection of a suitable graft is crucial, especially in pediatrics, due to recurrent episodes of respiratory tract infection, which threaten surgical success. 9 Our results have shown an excellent graft uptake (95%), which are similar to those observed by ElTaher et al 7 (93%), Rao et al 8 (96%) Elmoursy and Elbahrawy 12 (95%), and ElBatawi et al 13 (93%).…”

“…3 To restore the integrity of a perforated drum, numerous grafting materials have been used, including the temporalis fascia, cartilage, veins, fat, the perichondrium, and the periosteum. [4][5][6][7] The type of grafting material is a critical factor in the success of the surgical procedure. 4 The temporalis fascia ranks first among other grafting tissues, with success rates ranging from 93% to 97%.…”

Chronic tympanic membrane perforation closure: from historical aspects to modern methods

“…В литературе также встречаются единичные сообщения об использовании других соединительнотканных аутотрансплантатов, в том числе широкой фасции бедра, венозной стенки, периоста, использование которых не нашло широкого применения в тимпанопластике [14][15][16].…”