Postauricular undersurface tympanic membrane grafting: A follow‐up report

Abstract

The authors review 1,939 chronic ear surgeries in which 1,556 underwent some form of tympanic membrane grafting. The overall take rate was 93%. There was no selection of cases with regard to presence of infection, cholesteatoma, polyps, or granulation tissue at the time of surgery. There appeared to be no difference in the take rate based upon age of the patient, presence of infection, or cholesteatoma. Autogenous and homograft fascia performed well and there was no significant difference in take rate. Complications were minimal and were related more to the disease process than the grafting technique per se. In addition to reviewing the long-term follow-up of the original technique the authors present a method of dealing with tympanic membrane retraction pockets. Called a cartilage tympanoplasty this procedure incorporates a large piece of full thickness tragal cartilage with attached perichondrium into the substance of the tympanic membrane. With 2 years follow-up at this writing, this procedure has markedly reduced postoperative retraction pockets and recurrent cholesteatoma.

A Comparative Study of Temporalis Fascia Graft and Vein Graft in Myringoplasty

“…The most likely explanation for this is that in most cases of chronic otitis media, even though the ossicular chain may appear normal, there is some factor of scar tissue which prevents total restoration of hearing [9]. The present study's hearing results are comparable to other series [9,10].…”

“…Paker et al [17] observed one case of debilitating tinnitus post operatively which was associated with sensorineural hearing loss. Glasscock et al [10] reported 1 % incidence of EAC stenosis in his study.…”

“…Pediatric age group was kept out of this study because this age group is still considered to have high failure rate because of possibilities of eustachian tube dysfunction, middle ear effusion and patient management problems [9][10][11]. Elderly population was excluded from the study because of many associated medical problems like diabetes mellitus, hypertension, presbyacusis and sensory neural hearing loss.…”

“…The difference in success rates between the graft materials was not statistically significant. Some of the important studies using TFG showed success rate of 80-99 % [9,10,19,20]. Similarly in the studies employing VG the results were 50-92 % [6,7,13,19,21].…”

“…Since overlay technique is associated with various complications like blunting of anterior meatal angle, lateral migration of the graft, epithelial pearls and graft cholesteatoma, underlay technique is routinely followed in our hospital. Regarding hearing results, both the methods carry equally good results [9,10,17].…”