The use of cartilage grafts in tympanoplasties is recommended in cases with a higher probability of failure. Many grafting techniques have been reported, including palisade, cartilage island, and cartilage shield grafts. Cartilage minimizes the inflammatory tissue reaction, ensures resistance against infection during the recovery process, and provides good support against the retraction by virtue of its rigidity.This study compared the anatomic and functional results of conchal cartilage, tragal cartilage, and temporal muscle fascia grafts in primary type 1 tympanoplasty. Between January 2007 and January 2011, 79 patients with subtotal dry tympanic membrane perforation and an intact ossicular chain underwent primary type 1 tympanoplasty in our clinic. The postoperative perforation closure ratios, air and bone pure tone averages, and mean air-bone gap (ABG) in the 3 groups were compared with the preoperative values. The improvement in the mean ABG was assessed.The perforation closure ratio was 80.6%, 100%, and 88.5% in the muscle fascia, conchal cartilage, and tragal cartilage groups, respectively, and the mean increase in the ABG was 5.7, 8.9, and 9.7 dB, respectively.The island graft with cartilage perichondrium, which has recently become popular, can be also used in type 1 tympanoplasty. Because it does not require a second incision, conchal cartilage can be used routinely in tympanoplasties performed via a postauricular approach.

RATIONALE: Aspirin exacerbated respiratory disease (AERD) comprises the triad of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and intolerance to cyclooxygenase-1 enzyme inhibitors such as aspirin. The prevalence of AERD remains unclear and few studies have compared the clinical characteristics of patients with AERD to those with CRSwNP or asthmatics without CRS. METHODS: ICD-9 codes were used to search electronic medical records (EMR) from a tertiary care center to identify 3 distinct patient groups: 1) CRSwNP alone; 2) CRSwNP+Asthma; and 3) AERD. For comparison, 300 patients diagnosed with asthma without CRS were randomly selected from the EMR. We evaluated clinical characteristics including lung function, sinus surgeries, and oral corticosteroid use. RESULTS: We identified 459 patients with CRSwNP alone, 412 with CRSwNP+Asthma, and 173 with AERD. The prevalence of AERD among all CRSwNP patients was 16%. AERD patients underwent two-fold more sinus surgeries (p<0.001) and were significantly younger at the time of their first surgery (40 6 13 years) than CRSwNP patients (43 6 14 years, p<0.05). Atopy was significantly more prevalent in patients with AERD (83%) or asthma (85%) than in CRSwNP (66%, p<0.05). FEV1% was significantly lower in AERD patients compared to asthmatics (80 6 18 vs 86 6 17, p<0.01). Finally, more patients with AERD (13%) had corticosteroid-dependent disease than CRSwNP+Asthma (4%, p<0.01) or asthma (1%, p<0.001). CONCLUSIONS: This is one of the largest studies comparing surgical and non-surgical AERD patients with CRSwNP patients and asthmatics. AERD is common among CRSwNP and is associated with more severe sinus disease and reduced lung function compared to CRSwNP patients and asthmatics respectively.

Subcutaneous SIT improved the olfactory performance in AR patients. Additional studies with larger patient populations and longer follow-up periods are needed to establish subcutaneous SIT as an effective treatment for olfactory disorders in these patients.

Our objective was to evaluate the relationship between subjective pulsatile tinnitus and petrous bone pneumatization. Twenty-five patients admitted between January 2012 and March 2012 were assessed. The control group data were obtained by assessment of petrous bone images of 25 cases in which paranasal sinus computed tomography (CT) was performed because of chronic sinusitis and in which no ear pathology was present. Temporal bone CT images of patients with subjective pulsatile tinnitus were compared with those of patients with no ear complaints. The presence of petrous bone pneumatization was evaluated by CT. Subjective pulsatile tinnitus complaints were present for 32 of 50 ears. Pneumatization was detected in the petrous bone of 22 (68.8%) of 32 ears with subjective pulsatile tinnitus. In the control group, 25 patients (50 ears) with no ear complaints were assessed. Petrous bone pneumatization was detected in 12 (24%) of 50 ears comprising the control group. There was a statistically significant difference between the 2 groups (P = 0.000 < 0.001). Petrous bone pneumatization might be the cause of the subjective pulsatile tinnitus.

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