Cartilage Palisade Tympanoplasty in Sinus and Tensa Retraction Cholesteatoma

Andersen, John Rastrup; Cayé‐Thomasen, Per; M, Tos

doi:10.1097/00129492-200211000-00002

Cited by 22 publications

(28 citation statements)

References 7 publications

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“…The most posterior palisade was placed with its posterior edge on top of the posterior bony annulus (Figures 1 and 2). 12,14,20,25,32 If the perforation was small and the inferior part of the drum was intact, the inferior ends of the palisades were usually placed under the remaining eardrum, without contact with the bony annulus. 20,25,32 In ears with ossiculoplasty, the placement of the palisades was adapted to the placement of the interposed ossicle.…”

Section: Otoscopic Findings and Cholesteatoma Typementioning

confidence: 99%

Combined Heermann and Tos (CHAT) technique in cholesteatoma surgery: surgical technique and preliminary results

et al. 2005

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The combined Heermann and Tos (CHAT) technique is the combination of Heermann's 'cartilage palisade tympanoplasty' and Tos's 'modified combined approach tympanoplasty = modified intact canal wall mastoidectomy'. The first author (Cem Uzun) performed the CHAT technique as a one-stage operation in 15 ears of 15 patients with cholesteatoma. Two patients (one with a follow up of less than six months and one who did not show up at the final re-evaluation) were excluded from the study. Median age in the remaining 13 patients was 37 years (range: 14-57 years). Cholesteatoma type was attic, sinus (Tos tensa type 1) and tensa retraction (Tos tensa type 2) in six, five and two ears, respectively. Cholesteatoma stage was Saleh and Mills stage 1, 2, 3, 4 and 5 in one, three, four, four and one ear, respectively. The eustachian tube was not involved with cholesteatoma in any ear. After drilling of the superoposterior bony annulus, transcanal atticotomy with preservation of thin bridge and cortical mastoidectomy with intact canal wall, the cholesteatoma was removed, and the eardrum and atticotomy were reconstructed with palisades of auricular cartilage. Type I tympanoplasty was performed in two ears, type II in nine ears and type III (stapes absent) in two ears, with either autologous incus (eight cases), cortical bone (two) or auricular cartilage (one). No complication occurred before, during or after surgery. Oto-microscopy and audiometry were done before and at a median of 13 months after surgery (mean 14 months, range 7-30 months). There was no sign of residual or recurrent cholesteatoma in any patient during the follow-up period. At the final examination, all ears were dry and had an intact eardrum except one with a small, central hole, which had been seen since the early post-operative period. Clean and stable attic retraction with a wide access was observed in two ears. Post-operative hearing at the final evaluation was better (change > 10 dB) than the pre-operative one in nine ears and did not change in the remaining four. Pre- and post-operative mean hearing values were, pure-tone average 47 and 35 dB (p = 0.01) and air-bone gap 30 and 20 dB (p = 0.02), respectively. With the CHAT technique, cholesteatoma can be completely and safely removed from the middle ear, and a durable and resistant reconstruction of the middle ear with reasonable hearing can be achieved. However, a further study should analyse long-term results of a larger patient group.

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Section: Otoscopic Findings and Cholesteatoma Typementioning

confidence: 99%

Combined Heermann and Tos (CHAT) technique in cholesteatoma surgery: surgical technique and preliminary results

et al. 2005

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“…In our series at Gentofte Hospital of 32 children with tensa cholesteatoma reconstructed with underlay cartilage palisade tympanoplasty, the results 37 months after surgery were better than in 32 ears with similar pathology reconstructed with fascia (Chapter 4) (Andersen et al 2002(Andersen et al , 2004. The mean hearing gain in the cartilage group was 11.5 dB, and in the fascia group was 4.9 dB.…”

Section: Underlay Tympanoplasty With Cartilage Palisades Compared Witmentioning

confidence: 78%

“…Thus three studies showed slightly better postoperative hearing in the cartilage groups, and one (Andersen et al 2002(Andersen et al , 2004 showed significantly better hearing 37 months after tympanoplasty with cartilage palisades than that achieved in tympanoplasty with fascia.…”

Section: Underlay Tympanoplasty With Cartilage Strips Compared With Umentioning

confidence: 92%

Proposals for the Methods of Clinical Research in Cartilage Tympanoplasty

Tos¹

2009

Cartilage Tympanoplasty

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“…24 From an experimental, purely acoustical point of view, the 0.5-mm plate seems preferable compared to the palisade technique, if the thickness of palisades are 1 mm. 25 However, the thickness of the palisades used presently are usually thinner, between 0.5 mm and 1 mm, 5,10,13,14 which is likely to have improved the acoustic transfer.…”

Section: Discussionmentioning

confidence: 99%

“…5,13,[20][21][22] In the ears operated on by this technique, the eardrum was reconstructed with multiple, thin, and elongated pieces of cartilage, placed parallel to the malleus handle (Fig. 1).…”

Section: Patient Materialsmentioning

confidence: 99%

Ten‐year results of cartilage palisades versus fascia in eardrum reconstruction after surgery for sinus or tensa retraction cholesteatoma in children

et al. 2009

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The cartilage palisade grafting technique appears superior with respect to prevention of long-term eardrum retraction. The occurrence of cholesteatoma recurrency and eardrum perforation seem to be independent of grafting material, although these results may be due to type 2 error (low number of ears). In sinus cholesteatoma surgery and in type III tympanoplasty, the long-term hearing results appear better when grafting cartilage palisades.

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Cartilage Palisade Tympanoplasty in Sinus and Tensa Retraction Cholesteatoma

Abstract: The palisade technique effectively prevented postoperative retraction of the eardrum. The postoperative hearing was good.

Cited by 22 publications

References 7 publications

Combined Heermann and Tos (CHAT) technique in cholesteatoma surgery: surgical technique and preliminary results

Combined Heermann and Tos (CHAT) technique in cholesteatoma surgery: surgical technique and preliminary results

Proposals for the Methods of Clinical Research in Cartilage Tympanoplasty

Ten‐year results of cartilage palisades versus fascia in eardrum reconstruction after surgery for sinus or tensa retraction cholesteatoma in children

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