The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis

Abstract

BackgroundTympanoplasty is a common procedure performed by Otolaryngologists. Many types of autologous grafts have been used with variations of techniques with varying results. This is the first systematic review of the literature and meta-analysis with the aim to evaluate the effectiveness of one of the techniques which is gaining popularity, the palisade cartilage tympanoplasty. PubMed, EMBASE, and Cochrane databases were searched for "palisade", “cartilage”, “tympanoplasty”, "perforation" and their synonyms.Main body of abstractIn total, 199 articles reporting results of palisade cartilage tympanoplasty were identified. Five articles satisfied the following inclusion criteria: adult patients, minimum 6 months follow-up, hearing and surgical outcomes reported. Studies with patients undergoing combined mastoidectomy, ossicular chain reconstruction, and/or other middle ear surgery were excluded. Perforation closure, rate of complications, and post-operative pure-tone average change were extracted for pooled analysis. Study failure and complication proportions that were used to generate odds ratios were pooled. Fixed effects and random effects weightings were generated. The resulting pooled odds ratios are reported. Palisade cartilage tympanoplasty has an overall take rate of 96% at beyond 6 months and has similar odds of complications compared to temporalis fascia (OR 0.89, 95% CI 0.62, 1.30). The air-bone gap closure is statistically similar to reported results from temporalis fascia tympanoplasty.ConclusionsCartilage palisade tympanoplasty offers excellent graft take rates and good postoperative hearing outcomes for perforations of various sizes and for both primary and revision cases. This technique has predictable, long-term results with low complication rates, similar to temporalis fascia tympanoplasty.

Randomized Clinical Trial Comparing Bucket Handle and Cartilage Tympanoplasty Techniques for the Reconstruction of Subtotal or Anterior Tympanic Membrane Perforation

“…In the systematic review and meta-analysis by Jeffery et al, they found that Palisade Cartilage Tympanoplasty has an overall take rate of 96% at beyond 6 months and has similar odds of complications compared to temporalis fascia. The air-bone gap closure is statistically similar to the reported results from temporalis fascia tympanoplasty [ 24 ].…”

Comparison of Temporalis Fascia and Transcanal Composite Chondroperichondrial Tympanoplasty Techniques

“…There are several techniques reported in the literature for cartilage myringoplasty including the cartilage-perichondrium composite graft, butterfly techniques, palisade cartilage tympanoplasty, and diced cartilage. 4 We used the cartilage-perichondrium graft technique in this study to maximize the graft acceptance rate by preventing the risk of mobilization of the graft.…”

“…In the meta-analysis conducted by Jeffery et al, the palisade cartilage tympanoplasty was found to have an overall 96% success rate with similar ABG closure level to temporalis fascia tympanoplasty. 4 Mohanty et al compared the clinical outcomes of endoscopic cartilage versus temporalis fascia grafting in anterior quadrant perforations and they reported an overall success rate as 91.9% in cartilage and 79% in fascia groups. The changes in ABG were similar in both groups.…”

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

“…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.…”