Cartilage graft in type I tympanoplasty: audiological and otological outcome

Gamra, O. Ben; Mbarek, C.; Khammassi, K; Methlouthi, N.; Ouni, H.; Hariga, I.; Zribi, S.; Koubaa, Jamel; Khedim, A. El

doi:10.1007/s00405-008-0645-5

Cited by 54 publications

(55 citation statements)

References 20 publications

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“…In this 380-patient study, they found that there were no anatomical and functional differences between the two groups. Based on these similar results, they suggested that using cartilage was the first choice in tympanoplasties (16).…”

Section: Resultsmentioning

confidence: 81%

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Transcanal Tympanoplasty with Cartilage-Perichondrium Composite Graft

Paltura¹,

Çelebi²,

Develioğlu³

et al. 2015

JAREM

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INTRODUCTIONA common cause of otitis media is the permanent perforation of the tympanic membrane (TM). This situation may lead to problems such as hearing loss and frequent otorrhea in patients. First, Berthold (1) tried to surgically repair a TM perforation with a skin graft in 1878. Later, Zöllner (2) and Wulstein (3) identified materials that could be used as grafts and methods, respectively. Today, the temporalis muscle fascia, perichondrium, and cartilage with perichondrium are most commonly used as graft materials (4).The overall aim of tympanoplasty is to prevent infection and discharge in the middle ear and restore hearing by TM perforation repair. Depending on the pathology in the middle ear, this operation can be performed with or without mastoidectomy. Tympanoplasties are traditionally classified as medial (underlay) or lateral (overlay). The landmark for this classification is the annulus tympanicus (AT). The operation is named according to the placement of the graft medial or lateral to the AT.The aim of this study is to evaluate the results of overlay cartilage perichondrium composite graft tympanoplasty with the transcanal approach. METHODSThis study was conducted by retrospectively examining the patient records. Ethics committee approval was obtained from the Haseki Training and Research Hospital (152/12.11.2014). The ages of patients ranged from 15 to 55 years. TM perforations of the operated patients were limited to a single quadrant. They had mild hearing loss and did not have otorrhea within the last 6 months. Each patient filled the required information form before the operation, and complications that may occur in the postoperative period were explained to them. Audiological tests and physical examination data were evaluated in the 6 th postoperative month.The operation was performed under general anesthesia. Tragal cartilage, covered on one side with the perichondrium, which is as large as the perforation and 0.5 mm at the thickest point was used as the graft material. The excess perichondrium was laid on the TM. Audiological tests and physical examinations were performed 6 months after the operation. Airway gains of the patients and air-bone gaps were evaluated by calculating the average of the hearing values of patients at 500 Hz, 1000 Hz, and 2000 Hz. Statistical AnalysisStatistical analyses of the averages of pre-and postoperative airbone gap were assessed using the paired t-test. RESULTSForty patients were included. Of these, 16 (40%) were females and 24 (60%) were males. Eighteen (45%) patients were operated in the right ear and 22 (55%) in the left ear. Post-surgery, the TM perforation was closed in 35 (87.5%) patients. The perforation could not be completely closed in 3 (7.5%) patients, but more than 50% closing occurred in the perforation in comparison to preoperative sizes. The perforation size did not change in 2 (5%) patients. Otorrhea occurred in the early postoperative period in these 2 patients, and the graft was discarded. An average of 9.4 dB (SD: ±5.20859) airway gain was...

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Section: Resultsmentioning

confidence: 81%

“…Similar ratios were also obtained in the study by Karaman et al (15). Ben Gamra et al (16) anatomically and audiologically compared the patients undergoing cartilage and fascia tympanoplasty. In this 380-patient study, they found that there were no anatomical and functional differences between the two groups.…”

Section: Resultsmentioning

confidence: 99%

Transcanal Tympanoplasty with Cartilage-Perichondrium Composite Graft

Paltura¹,

Çelebi²,

Develioğlu³

et al. 2015

JAREM

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“…These results are similar to Gamra et al where they observed good functional hearing results (ABG <20 dB) in 89% with cartilage graft and 82.8% with temporalis fascia graft (p >0.005). 19 The current study suggests that palisade cartilage graft and temporalis fascia graft for tympanic membrane perforation closure are comparable. The disadvantage of using thicker cartilage, thought to interfere with hearing and sound conduction, was overcome by slicing them to achieve a thickness comparable with that of the temporalis fascia.…”

Section: Air Bone Gap Closurementioning

confidence: 90%

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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“…Timpanik membranın perforasyonunun onarımında greft materyali olarak değişik greft materyalleri kullanılmışsa da en sık kullanılan greft materyalleri temporal kas fasyası ve perikondriumdur (3)(4)(5)(6)(7)(8). Temporal kas fasyası 1950'lerden beri kullanılan kullanımı ve elde edilmesi kolay bir greft materyalidir (5-7).…”

Section: Discussionunclassified

“…Timpanoplastide timpanik membran perforasyonunun onarımı için temporal kas fasyası, perikondrium ve kartilaj gibi dokular değişik teknikler uygulanarak kullanılmaktadır (1)(2)(3). İlerlemiş orta kulak patolojileri, retraksiyon poşlarının varlığı ve atelektatik kulaklarda greft materyali olarak kullanılan temporal kas fasyasının atrofiye olma olasılığı fazla olduğu için bu tür vakalarda perikondrium kullanılmasının daha uygun olacağı yönünde yayınlar her geçen gün artmaktadır (4).…”

Section: Introductionunclassified

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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Cartilage graft in type I tympanoplasty: audiological and otological outcome

Cited by 54 publications

References 20 publications

Transcanal Tympanoplasty with Cartilage-Perichondrium Composite Graft

Transcanal Tympanoplasty with Cartilage-Perichondrium Composite Graft

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

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

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