Homograft septal cartilage for attic support in intact canal wall tympanomastoidectomy and tympanoplasty

Jj, Pappas; Ha, Bailey; Rn, McGrew; Ss, Graham

doi:10.1288/00005537-198109000-00007

Cited by 18 publications

(5 citation statements)

References 5 publications

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“…Sources of cartilage include ear tragus, knee meniscus, rib cartilage, and nasal septum. 4–9 Cartilage has demonstrated good results in tympanic membrane reconstruction but has the reputation of sacrificing maximum hearing improvement, because of “loading” of the middle ear mechanism with increased mass and stiffness. 10 …”

Section: Introductionmentioning

confidence: 99%

Revision Tympanoplasty Utilizing Fossa Triangularis Cartilage

Moore¹

2002

The Laryngoscope

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Fossa triangularis cartilage is thinner and has less mass than tragal cartilage. This creates a relatively mobile neotympanic membrane that can be monitored postoperatively by standard tympanometry, and allows for excellent hearing results. Recurrent tympanic membrane perforation or atelectasis with or without bony canal erosion that has failed standard fascia graft tympanoplasty can be successfully repaired with fossa triangularis cartilage graft tympanoplasty. Primary surgical use of cartilage graft tympanoplasty should be considered in patients with high-risk otologic disease, since fossa triangularis cartilage is thick enough to resist prolonged negative middle ear pressure and the hearing results with fossa triangularis cartilage shield graft tympanoplasty are comparable to those reported with fascia grafting. In patients with type A or C tympanogram results following successful fossa triangularis cartilage grafts, standard impedance testing can be used to clinically evaluate tympanic membrane mobility and help identify the presence of middle ear disease. However primary placement of a tympanostomy tube should be performed in patients with granulation tissue in the middle ear at time of tympanoplasty. Further study is needed to determine the ideal thickness of cartilage for tympanic membrane reconstruction.

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Section: Introductionmentioning

confidence: 99%

Revision Tympanoplasty Utilizing Fossa Triangularis Cartilage

Moore¹

2002

The Laryngoscope

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“…Basic materials have included autografts, homografts, and heterografts of soft tissue, cartilage, and bone. [1][2][3][4][5][6][7][8][9] Synthetic materials have also been used successfully to repair the osseous canal wall. 10 -13 The desirability of using autologous tissues for repair, especially in chronic otitis media, led me to begin using autologous bone in the form of mortar or pate for this purpose in 1973.…”

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confidence: 99%

Tympanomastoid Surgery: A Technique for Repairing Posterior Osseous Canal Wall Defects with Autologous Temporalis Fascia and Bone Pâte

Althaus

1985

Otolaryngol.--head neck surg.

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A technique for repairing small to medium-sized defects in the osseous posterior superior canal resulting from pathologic or iatrogenic causes is described. Bone pâte is harvested from the mastoid cortex by means of a simple collection technique. A sandwich graft composed of autologous temporalis fascia lined with bone pâte is used to fill in the canal wall defect. This technique has been used successfully in 27 of 28 cases, with follow-up as long as 8 years. When fully healed, the bone graft has attained the texture and consistency of the normal osseous canal and, if necessary, can be curetted or drilled for reshaping during planned second-stage tympanomastoid surgery. The temporalis fascia/bone pâte graft technique is simple, easy to learn, and has proven to be a reliable method for repairing the defects described.

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“…Pappas et al [33] used homograft nasal septal cartilage for attic support with a success rate of 84%. Kinney [34] reported that the number of recurrences are reduced with attic obliteration by cartilage and perichondrium.…”

Section: Discussionmentioning

confidence: 99%

Intact Canal Wall Tympanomastoid Surgery: 10 Years Experience

Sonkhya

Mittal

Sonkhya

2011

Indian J Otolaryngol Head Neck Surg

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310 cases of chronic middle ear disease were managed by Intact canal wall tympanomastoid surgery. Intact canal wall tympanomastoid surgery technique used in this study has been compared with the Jansen's classic ICW technique. A retrospective analysis of 310 cases of chronic middle ear pathology managed by Intact canal wall technique over a period of 10 years (January 1996 to December 2005) was conducted. Patients information was collected from the patients record. 310 patients, aged 5-60 years, were managed by Intact canal wall technique and followed for a minimum period of 5 years. The male:female ratio in our study was 1.25:1 (172 males:138 females). The ratio of adult to pediatric patients was 2.7:1 (226 adults:84 children). Out of 274 (88.4%) cases having a regular follow up, 196 (71.6%) were found to be stable. Postoperative retraction of the tympanic membrane was observed in 24 (8.8%) cases and was managed by the placement of ventilation tube. Secretory otitis media was seen in 14 (5%) cases and was managed by myringotomy and placement of ventilation tube. 17(12.4%) cases were revised including recurrent disease (10 cases), residual disease (6 cases), graft failure (12 cases), stenosis of the ear canal (4 cases), meatomastoid fistula (2 case). Our technique of Intact canal wall tympanomastoid surgery takes less time than the classic Jansen's technique, is easily reproducible and taught, is a single stage procedure and can be universally applied to various chronic middle ear pathologies as the primary treatment with low recidivism rate.

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Homograft septal cartilage for attic support in intact canal wall tympanomastoidectomy and tympanoplasty

Cited by 18 publications

References 5 publications

Revision Tympanoplasty Utilizing Fossa Triangularis Cartilage

Revision Tympanoplasty Utilizing Fossa Triangularis Cartilage

Tympanomastoid Surgery: A Technique for Repairing Posterior Osseous Canal Wall Defects with Autologous Temporalis Fascia and Bone Pâte

Intact Canal Wall Tympanomastoid Surgery: 10 Years Experience

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