Type III cartilage “shield” tympanoplasty: An effective procedure for hearing improvement

Kyrodimos, Efthymios; Sismanis, Aristides; Santos, Daniel Marcelino dos

doi:10.1016/j.otohns.2006.12.025

Cited by 36 publications

(29 citation statements)

References 6 publications

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“…They also reported no cases of extrusion. In 2007, Kyrodimos et al [8] presented their experience of the so-called "type III cartilage shield tympanoplasty, " which consisted of repairing large tympanic membrane perforation and ossicular discontinuity with one piece of full thickness conchal cartilage shaped as a shield. They used the cartilage shield to replace the entire tympanic membrane and reconstructed sound transmission by placing the cartilage on the head of the stapes.…”

Section: Discussionmentioning

confidence: 99%

“…In an exclusive large pediatric cohort, Nevoux et al [10] reported the results of the cartilage shield tympanoplasty technique. Unlike Kyrodimos et al [8] , Nevoux et al [10] interposed two additional pieces of cartilage between the stapes capitulum. At 1 year, closure of the ABG to within 20 dB was achieved in 62.2% of the cases, which is an interesting result in children taking into account the frequent onset of otitis media with effusion in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

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Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma

Denis¹,

Manac'h²,

Teszler³

et al. 2017

Int Adv Otol

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Original Article INTRODUCTIONThe double cartilage block ossiculoplasty for partial ossicular reconstruction in the presence of an intact stapes was described in 1987 by Luetje and Denninghoff [1] . This technique offers several advantages-it is easy to perform, uses well-tolerated autologous materials, and has no additional cost. Despite those advantages and encouraging hearing results, this interesting ossiculoplasty technique is not very popular among otologists.For several years we have routinely used this technique at our institution, and we commonly refer to it as cartilage ossiculoplasty from stapes to tympanic membrane (COST). We decided to evaluate our results with this technique in a retrospective case-control study and to compare these to results published in studies dealing with other partial ossicular chain reconstruction techniques.To obtain a homogenous series, we selected patients having undergone a COST during a one-stage intact canal wall tympanoplasty (ICW) for cholesteatoma, even if this condition is probably one of the worst for achieving good hearing results. MATERIALS and METHODSAmong all surgical procedures performed at our institution for chronic otitis media between January 1999 and August 2006, we retrospectively selected the files of patients having undergone a COST during a primary one-stage ICW for middle ear and/or mastoid acquired cholesteatoma. We excluded ossiculoplasty procedures performed in case of chronic otitis media without cholesteatoma, canal wall-down tympanoplasties (CWD), ICW with staged ossiculoplasty, ossiculoplasties performed with other material than cartilage (incus, malleus head, hydroxyapatite, or titanium prosthesis), and cases where the stapes superstructure was missing. ICW included transcanal removal of a middle ear cholesteatoma and canal wall-up tympanoplasty.Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma OBJECTIVE: To report hearing results of cartilage interposition ossiculoplasty in one-stage intact canal wall (ICW) tympanoplasty for cholesteatoma with intact stapes. MATERIALS and METHODS:A retrospective study of pre and postoperative hearing status was conducted at a tertiary referral otologic center in a series of 61 patients having undergone one-stage ICW tympanoplasty for cholesteatoma with intact stapes and cartilage ossiculoplasty during the same procedure. RESULTS:In the preoperative period, the mean air conduction thresholds (AC), air-bone gap (ABG), and speech reception thresholds (SRT) were 35.3, 20.14, and 35.6 dB, respectively. Postoperatively, with a mean follow-up of 29 months, AC, ABG, and SRT were 27.8, 13.34, and 28.8 dB, respectively. Mean hearing gain was 6.8 dB and mean SRT improvement was 6.8 dB. Mean bone conduction thresholds for 1, 2, and 4 kHz remained stable after surgery (17.6 dB preoperatively vs. 18 dB postoperatively). CONCLUSION:Cartilage ossiculoplasty from stapes to tympanic membrane in one-stage ICW tympanoplasty for cholesteatoma is a safe, relia...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma

Denis¹,

Manac'h²,

Teszler³

et al. 2017

Int Adv Otol

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“…Small defects that remain after reconstruction with a cartilage piece are filled up by bits of temporalis muscle or smashed cartilage. 4 Temporalis fascia kept lateral to the piece of cartilage and also to cover any defects in tympanic membrane by underlay method. Adequate gelfoam kept in mesotympanum, mastoid and also in the ear canal.…”

Section: Methodsmentioning

confidence: 99%

Outcome of intact canal wall mastoidectomy in limited attic cholesteatoma

Reddy

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Surgery for cholesteatoma has evolved over the years in terms of efficacy and patient compliance and better life. Intact canal wall technique is best in terms of normalization of the physiology of the ear along with eradication of disease. Hence this study is undertaken to evaluate a technique of intact canal wall mastoidectomy for limited attic cholesteatoma and to study practical considerations during surgery.Methods: Any person undergoing surgery for attic cholesteatoma has to be thoroughly examined during surgery and decision for doing a canal wall up (CWP) surgery will be taken on the operating table. The patients were regularly followed up and microscopic, otoendoscopic and audiological assessments done at regular intervals. Revision surgery was done only if there were signs of recidivism or if ossiculoplasty was planned for second stage or placement of prosthesis later was considered. Results: Out of 100 cholesteatoma surgeries, 22 cases found suitable for the CWU technique. Only 1 out of 22 patients required revision surgery due to recurrence. Rest of the patients maintained healthy middle ear for more than a year. Prevention of medialization of attic cartilage piece was found to be a very important consideration.Conclusions: The CWU technique is a reliable method of management for limited attic cholesteatoma. Selection of subjects should be very meticulous.

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“…In 4 patients, the long process of Incus was partially eroded and a small piece of cartilage was used to bridge the gap between stapes head and remaining of Incus. In 2 of the patients, only stapes was present where a type III cartilage shield tympanoplasty [4] was carried out. In 4 patients, all ossicles were absent and no ossiculoplasty was performed in them.…”

Section: Methodsmentioning

confidence: 99%

Atticotomy, Attic Reconstruction, Tympanoplasty with or Without Ossiculoplasty, Canal Plasty and Cortical Mastoidectomy as Part of Intact Canal Wall Technique for Attic Cholesteatoma

Vadiya

Kedia

2015

Indian J Otolaryngol Head Neck Surg

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To evaluate a technique of canal wall up mastoidectomy for limited attic cholesteatoma and to study practical considerations during surgery. Any person undergoing surgery for attic cholesteatoma was thoroughly examined during surgery and decision for doing this canal wall up (CWU) surgery will be taken on operating table. The patients were regularly followed up and microscopic, oto endoscopic and audiological assessments done at regular intervals. Revision surgery was done only if there were signs of recidivism or if ossiculoplasty was planned for second stage or placement of a prosthesis later was considered. Out of 100 cholesteatoma surgeries, 22 cases found suitable for the CWU technique. Only 1 out of 22 patients required revision surgery due to recurrence. Rest of the patients maintained healthy middle ear for more than a year. Prevention of medialisation of attic cartilage piece was found to be very important consideration. The CWU technique is a reliable method of management for limited attic cholesteatoma. Selection of subjects should be very meticulous.

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Type III cartilage “shield” tympanoplasty: An effective procedure for hearing improvement

Abstract: Type III cartilage "shield" tympanoplasty is an effective technique for hearing improvement in selected patients with chronic otitis media. The results of this procedure are similar to those obtained with partial ossicular replacement prosthesis.

Cited by 36 publications

References 6 publications

Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma

Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma

Outcome of intact canal wall mastoidectomy in limited attic cholesteatoma

Atticotomy, Attic Reconstruction, Tympanoplasty with or Without Ossiculoplasty, Canal Plasty and Cortical Mastoidectomy as Part of Intact Canal Wall Technique for Attic Cholesteatoma

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