Temporalis Fascia and Cartilage-Perichondrium Composite Shield Grafts for Reconstruction of the Tympanic Membrane

Yetışer, Sertaç; Hıdır, Yusuf

doi:10.1177/000348940911800807

Cited by 35 publications

(42 citation statements)

References 19 publications

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“…Some studies advocate that especially in revision tympanoplasty, the success rate of the graft can be increased by adding mastoidectomy [21] . However, there are studies advocating that in tympanoplasty in which cartilage graft is used, adding mastoidectomy does not affect the success rate of the graft and gain in hearing [3,5,16,22] . In our case series, antrum and mastoid aeration disorders were detected on the temporal CT of 12 (36.4%) patients, and mastoidectomy was added to the surgery.…”

Section: Discussionmentioning

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%

“…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] . In our study, no patient had postoperative deterioration of hearing.…”

Section: Discussionmentioning

confidence: 99%

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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“…Hastanın yaşının küçük olması, perforasyonun yeri ve boyutu, anemi, malnutrisyon gibi iyileşmeyi olumsuz etkileyecek kronik hastalıklar orta kulakta enfeksiyon varlığı, östaki tüpü disfonksiyonu ve perforasyonun bilateral olması gibi faktörler hasta ile ilgili faktörlerdir (18). Diğer faktörler arasında cerrahi teknik, cerrahın tecrübesi, greft materyalinin cinsi sayılabilir (18)(19)(20)(21).…”

Section: Discussionunclassified

“…Perikondrium dokusu daha sağlam bir doku olduğu için daha çok timpanik membran retraksiyonu olan subtotal perforasyonlarda veya açık teknik yapılmış vakalarda kartilajla ve kartilaj olmadan da kullanılmaktadır (8,11,21). Greft materyali olarak kullanıldığın-da Kartilaj, perikondriuma ve kas fasyasına göre daha rijid olduğu için, odyometrik sonuçlar daha düşük olmaktadır (21).…”

Section: Discussionunclassified

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Hearing Results in Type 1 Tympanoplasty Using with Tragal Cartilage and Temporalis Muscle Fascia

Dalğıç¹,

Kandoğan²

2014

JAREM

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ÖZETAmaç: Biz bu çalışmada timpanik membran perforasyonu olan kolesteatomsuz, timpanik membran retraksiyonu ve kemikçik zincir problemi olmayan kronik otitis media'lı, hastalarda greft olarak temporal kas fasyası ve perikondrium kullanımının uzun dönem odyolojik sonuçlarını karşılaştırmayı amaçladık.Yöntemler: Bu çalışmaya timpanik membran perforasyonu nedeniyle Tip 1 timpanoplasti yaptığımız kolesteatomsuz kronik otitis medialı 35 hasta dahil edilmiştir. Tüm hastalara hem pre operatif hem de post operatif 1 yılda tonal odyometri yapılmıştır ve 500, 1000, 2000 ve 4000Hz de kemik ve hava yolu işitme seviyeleri kaydedilmiştir. This study aimed to compare the long-term result of hearing in patients with tympanic membrane perforation without cholesteatoma and ossicle problems using the temporalis fascia and perichondrium.Methods: It included 35 patients with chronic otitis media without cholesteatoma who underwent type 1 tympanoplasty due to tympanic membrane perforation. Preoperative and 1-year postoperative air-bone gap (ABG) and postoperative gain in ABG at frequencies of 0.5, 1, 2, and 4 kHz were recorded.Results: The 35 patients were operated. Tragal perichondrium was used in the 20 patients. Temporalis muscle fascia was used in 15 patients. There was statistically significant difference between preoperative and after the operation at the first year in the group that used the perichondrium and the temporalis muscle fascia group. There was no statistically significant difference in air bone gap gain between perichondrium and temporalis muscle groups.Conclusion: There was no difference in hearing results between procedures where the perichondrium was used for reconstruction of the tympanic membrane as temporalis muscle fascia. (JAREM 2014; 1: 4-6)

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Temporalis Fascia Graft Perforation and Retraction After Tympanoplasty for Chronic Tubotympanic Otitis and Attic Retraction Pockets

Jesić

Dimitrijević²,

Nešić³

et al. 2011

Arch Otolaryngol Head Neck Surg

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Temporalis Fascia and Cartilage-Perichondrium Composite Shield Grafts for Reconstruction of the Tympanic Membrane

Abstract: The hearing gain in patients with cartilage shield grafting was better than that in those who had temporalis fascia tympanoplasty, although experimental analysis shows loss of acoustic energy for thick and large shield cartilage grafts.

Cited by 35 publications

References 19 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

Hearing Results in Type 1 Tympanoplasty Using with Tragal Cartilage and Temporalis Muscle Fascia

Temporalis Fascia Graft Perforation and Retraction After Tympanoplasty for Chronic Tubotympanic Otitis and Attic Retraction Pockets

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