Primary cartilage tympanoplasty: our technique and results

Khan, Mubarak Muhamed; Parab, Sapna Ramkrishna

doi:10.1016/j.amjoto.2010.07.010

Cited by 64 publications

(85 citation statements)

References 10 publications

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“…Other studies for different authors showed a success rate ranging from 93.2%, 8 97%, 9 97.7%, 10 98.2 11 to 100% 12 which is in agreement with our results.…”

Section: Discussionsupporting

confidence: 96%

Audiological and otological outcome in Bi-island chondroperichondrial graft type I tympanoplasty

Hasaballah

Hamid

Hamdy

2014

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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Background: The principal aims of a tympanoplasty operation are to create an intact tympanic membrane and to restore an optimal hearing improvement. Many surgeons have used cartilage for grafting due to its increased stability and resistance to negative pressure. Cartilage has been criticized because of concerns regarding hearing results.Objectives: The aim of this study is to present the experience of using cartilage for grafting central perforations in type I tympanoplasty procedure with some novel modifications and evaluate its take rate and audiologic results.Methods: This is a prospective study including 40 patients (45 ears) who underwent type I cartilage tympanoplasty. All patients are primary cases of chronic suppurative otitis media of tubotympanic type. The following parameters were evaluated at least after 3 months from surgery: graft take and change between the pre-and post-operative pure-tone average air-bone gap (PTA-ABG).Results: Thirty-nine patients included in the study underwent 45 cartilage tympanoplasty type I operations. The mean age of the patients was 24.9 ± 9.5 years (range, 15-51 years). The mean follow up period was 6.2 months (range, 3-9 months). All perforations were found to be closed with a 100% graft take rate. The overall mean pre-operative PTA-ABG was 26.0 ± 4.4 dB, whereas the postoperative PTA-ABG was 13.8 ± 5 dB (p < 0.0001) which is highly significant. The percent of reduction of PTA-ABG was about 46.6%.Conclusion: Bi-island chondroperichondrial type I tympanoplasty is an effective and reliable technique with a high success rate and minimal complications.

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“…Other studies for different authors showed a success rate ranging from 93.2%, 8 97%, 9 97.7%, 10 98.2 11 to 100% 12 which is in agreement with our results.…”

Section: Discussionsupporting

confidence: 96%

Audiological and otological outcome in Bi-island chondroperichondrial graft type I tympanoplasty

Hasaballah

Hamid

Hamdy

2014

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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“…Karaman et al (22) reported that the rate of composite cartilage island graft closure of the tympanic membrane in 74 patients was 97.3% and that ABG improvement was 20.2 dB. Khan et al (23) reported a closing rate of 98.20% and an average improvement of 7.06 dB ABG in the study that they carried out using thinned tragal cartilage grafts. Kirazlı et al (25) reported a postoperative ABG improvement of 11.9 dB in their cartilage group and 11.5 dB in their fascia group; there was no significant difference between the groups in their study.…”

Section: Discussionmentioning

confidence: 91%

Long-Term, High-Frequency Tympanometry and Audiometry Results after Cartilage and Fascia Tympanoplasty

Özdamar¹,

Taşkın²,

Aydın³

et al. 2014

Turk Arch Otolaryngol

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Objective: Fascia or cartilage can be used as grafts in tympanoplasty; however, the disadvantage of cartilage is that it causes stiffness and rigidity in the newly formed tympanic membrane. The aim of this study was to compare the long-term high-frequency tympanometry and audiometry outcomes of tympanoplasty using cartilage and fascia.Methods: Forty patients in whom tragal cartilage was used in type 1 tympanoplasty and 40 patients in whom temporal muscle fascia was used were included in the study. The preoperative and postoperative audiometries of the two groups were compared. Postoperative highfrequency tympanometry (224, 668, 800, and 1000 Hz) and air volume, compliance, and pressure differences of the two groups were also compared. Results:The mean age of the patients was 31.3±4.5 year. The success rates were 96% in the cartilage group and 92% in the fascia group. In the fascia group, the preoperative mean air bone gap was 27.9±97 decibels (dB), and the postoperative mean air bone gap was 19.1±7.6 dB. The postoperative mean air bone gap improvement was 8.8±9.9 dB; the difference was statistically significant. In the cartilage group, the preoperative mean air bone gap was 28.2±9.6 dB, and the postoperative mean air bone gap was 17.2±10.5 dB. The postoperative mean air bone gap improvement was 10.9±10.3 dB; the difference was statistically significant. When postoperative mean air bone gap improvement was compared, there was no statistical difference between the two groups. When high-frequency tympanogram values were compared, there were no significant differences between the two groups at 224, 668, 800, or 1000 Hz frequencies in terms of air volume, compliance, or pressure values. Conclusion:The use of temporal muscle fascia and cartilage in tympanoplasty is statistically similar when compared in terms of tympanic membrane repair, hearing gain, air volume, pressure, and compliance. For this reason, cartilage graft can easily be preferred in tympanoplasty, especially in revision cases and adhesive otitis media, without fear of stiffness or rigidity effects.

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“…5 Khan et al used a shield-sliced tragal cartilage-perichondrium composite graft, and their success rate was 97.67%. 13 Sismanis et al reported their revision tympanoplasty cases, and their success rate was 93.5%. 14 Dornhoffer et al, also reported 100% uptake rate.…”

Section: Graft Used Take Up In % Hearing Results Khan Et Al [13]mentioning

confidence: 99%

Is cartilage- perichondrium composite graft tympanoplasty the ideal treatment for revision tympanoplasty

Tyagi¹,

Tyagi²,

Srivastava³

et al. 2016

Int J Otorhinolaryngol Head Neck Surg

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INTRODUCTIONTympanoplasty has undergone tremendous evolution since it was first described by by Wullstein in 1952 andZoellner in 1955. 1,2 Over the decades various autologus (temporalis fascia, fascia lata, periosteum, perichondrium, cartilage with or without peri-chondrium, veins, fatty tissue, and skin) and homologus (dura mater, pericardium, cartilage, amniotic membrane, skin, cornea, peritoneum, veins, and aortic valve) grafting materials and techniques were used in tympanoplasty operations.3 Temporalis fascia remains the most commonly used material for tympanic membrane reconstruction, with a success rate of 93% to 97% in primary tympanoplasties. 4 In high risk situations such as the subtotal perforation, atelectatic ear, cholestetoma, and revision tympanoplasty, the results have not been found to be commendable. In these situations, fascia and perichondrium have shown to undergo atrophy and subsequent failure in post-operative period.5 Heerman claimed to have used the cartilage palisade technique for middle ear and mastoid cavity reconstruction since 1960, in over 13,000 cases. Reconstruction of tympanic membrane with cartilage counteracts the tendency to retraction of soft autologus materials like temporalis fascia or perichondrium. Because of its low turn-over rate, cartilage is more resistant to infection. 6 METHODS55 patients who underwent revision tympanoplasty were taken from the department of Otorhinolaryngology, Harsh ENT Hospital, Ghaziabad. Data were collected from the record section and analysed in various aspects. A retrospective chart review was performed of all patients who underwent cartilage composite graft revision tympanoplasty. All the cases were thoroughly examined and investigated before taking them for surgery, findings ABSTRACT Background: The objective of the study was to evaluate the anatomical and audiological outcomes of cartilageperichondrium composite graft tympanoplasty by underlay technique in revision tympanoplasties. Methods: A series of 55 patients who underwent revision tympanoplasty with cartilage-perichondrium composite Island graft, at the department of Otorhinolaryngology, Harsh ENT Hospital, Ghaziabad. Tympanoplasty with cartilage-perichondrium composite island graft was done using underlay technique after slicing the cartilage with help of slicer. Ossiculoplasty was performed as and when needed. Results: Graft uptake rate was found to be 96.36% (53 of the 55 cases) in our study without any serious complications. Audiological outcomes with closure of 94.55% air bone gap within 0 to 30 dB was achieved (p <0.05). Conclusions: Nearly 97% success rate can be achieved with cartilage-perichondrium composite graft tympanoplasty for Revision tympanoplasty.

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Primary cartilage tympanoplasty: our technique and results

Cited by 64 publications

References 10 publications

Audiological and otological outcome in Bi-island chondroperichondrial graft type I tympanoplasty

Audiological and otological outcome in Bi-island chondroperichondrial graft type I tympanoplasty

Long-Term, High-Frequency Tympanometry and Audiometry Results after Cartilage and Fascia Tympanoplasty

Is cartilage- perichondrium composite graft tympanoplasty the ideal treatment for revision tympanoplasty

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