Type III Tympanoplasty applying the Palisade Cartilage Technique: A Study of 61 Cases

Neumann, Andreas; Schultz-Coulon, H.-J.; Jahnke, K.

doi:10.1097/00129492-200301000-00008

Cited by 38 publications

(37 citation statements)

References 12 publications

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“…Shield-sliced tragal cartilage-perichondrium 97.67% Air bone gap < 30 dB Sismanis et al [14] Revision cartilage tympanoplasty 93.5% Air bone gap < 30 dB Neuman et al [5] Cartilage palisade 100% Air bone gap < 30 dB H.Chopra et al [9] Temporalis fascia with anterior tucking 95% Air bone gap < 30 dB Dornhoffer et al [8] Cartilage palisade 100% Air bone gap < 20 dB Ioanis Adonis et al [10] Cartilage graft 98.4% Air bone gap < 20 dB K.Desarda et al [11] Cartilage graft 96% Air bone gap < 20 dB Our study Cartilage-perichondrium composite graft 96.36% Air bone gap <30 dB…”

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

confidence: 99%

“…Neumann et al reported a graft take rate of 100% in their palisade cartilage tympanoplasty study, and they did not observe resorption or recurrent defects of the rebuilt tympanic membrane. 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%.…”

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

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

confidence: 99%

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

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…Neuman et al [11] reported post operative recurrence in 1.6 % cases with no facial weakness and otorrhea.…”

Section: Postoperative Complicationsmentioning

confidence: 98%

Tympanoplasty in Subtotal Perforation with Graft Supported by a Slice of Cartilage: A Study with Near 100 % Results

Mundra

Sinha

Agrawal

2013

Indian J Otolaryngol Head Neck Surg

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The aim of this study is to evaluate the results of closure of subtotal perforation by tympanoplasty using underlay technique with the perichondrium/temporalis fascia graft supported by single cartilage slice anteriorly. Our hypothesis was that the cartilage support, single slice, offers an extremely reliable method for reconstruction of the tympanic membrane in cases of advanced middle ear pathology and Eustachian tube dysfunction. Retrospective and prospective study of patient undergoing tympanoplasty in subtotal perforation with graft supported by a slice of cartilage between March 2000 and October 2005. Intact perichondrium/temporalis fascia was placed as graft in subtotal perforation, supported by a slice of cartilage. Slice was placed anteriorly from hypotympanum to anterior part of attic. It does not obstruct Eustachian tube opening, as it is curved with concavity facing towards medial wall and lined by perichondrium without any raw area, which prevents adhesion formation. Hearing results were reported using four frequency (500, 1,000, 2,000 and 3,000) pure tone average air-bone gap. During the study period, perichondrium/temporalis fascia graft with support of cartilage slice was used for tympanic membrane reconstruction in 94 patients. Overall graft take rate was 98.94 %. In 95.74 % of patients of different types of tympanoplasty achieved hearing level of 30 dB or less. Complications included residual perforation in (1.06 %), infection or gaping of wound in 2 (2.13 %). Cartilage slice support offers an extremely reliable method for reconstruction of tympanic membrane in cases of high-risk perforation (subtotal perforation, retraction pocket, cholesteatoma, anterior perforation of tympanic membrane).

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“…The thought of a prospective study using cartilage as to reconstruct the tympanic membrane came after going through the limited number of clinical studies exploring the outcomes of cartilage palisade in tympanoplasty procedures. [8][9][10][11][12] The aim of this article was to compare the graft acceptance rates and auditory outcomes of cartilage tympanoplasty operations using the palisade technique with those of primary tympanoplasty using temporalis fascia in two groups of patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes of palisade cartilage with temporalis fascia following tympanoplasty at a tertiary care centre in Nepal

Jaiswal

Chettri

Shah

et al. 2016

Int J Otorhinolaryngol Head Neck Surg

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Background: Mucosal type of chronic otitis media is a common disease worldwide with 5.2% prevalence in Nepal. Cartilage material is criticized in terms of hearing results due to its thickness. The objective of this study was to compare graft uptake and post-operative hearing of palisade cartilage with temporalis fascia following tympanoplasty.Methods: A prospective randomized study conducted over 12 months included subjects of chronic otitis media mucosal inactive having dry ear for at least 4 weeks. 76 subjects were enrolled and reviewed on 6th post-operative day, 6th and 12th post-operative week. The graft uptake and post-operative hearing were evaluated. The results were compared within and between the groups. Results: The graft uptake on 42nd and 90th post-operative days were comparable with no statistical difference. The difference of mean pre-operative, 42nd and 90th post-operative air bone gaps in palisade cartilage and temporalis fascia were also comparable. The results were statistically significant, showing improvement in hearing after surgery. Closure of air-bone gap within 30 dB was achieved in 71.87% in temporalis fascia and 88.89% in palisade cartilage. The intergroup difference was not statistically significant.Conclusions: The graft uptake rates and hearing results after palisade cartilage are similar to temporalis fascia.

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Type III Tympanoplasty applying the Palisade Cartilage Technique: A Study of 61 Cases

Cited by 38 publications

References 12 publications

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

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

Tympanoplasty in Subtotal Perforation with Graft Supported by a Slice of Cartilage: A Study with Near 100 % Results

Comparison of outcomes of palisade cartilage with temporalis fascia following tympanoplasty at a tertiary care centre in Nepal

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