Revision Chronic Ear Surgery

Kaylie, David M.; Gardner, Edward K.; Jackson, C. Gary

doi:10.1016/j.otohns.2005.10.044

Cited by 56 publications

(39 citation statements)

References 16 publications

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“…Temporalis fascia and perichondrium alone often fails as graft material for tympanic membrane reconstructions because of their low mechanical stability and tendency to atrophy over the years [2,3]. The ''Take'' rate for these materials ranges between 86 and 97% [21][22][23][24]. The advantages of cartilage is high mechanical stability and long lasting vitality ever years after surgery.…”

Section: Discussionmentioning

confidence: 99%

Cartilage–Perichondrium: An Ideal Graft Material?

Chhapola¹,

Matta²

2011

Indian J Otolaryngol Head Neck Surg

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Temporalis fascia has long been regarded as the ideal graft material for tympanic membrane repair. However it often does not seem to withstand negative middle ear pressure in the post operative period. Tragal cartilage with perichondrium would appear to be a better graft material with good hearing outcome. It can be obtained easily with cosmetically acceptable incision. In the present study, we have compared the graft properties of temporalis fascia verses tragal cartilage perichondrium with respect to healing, hearing and rate of post operative retraction or reperforation. 132 patients of chronic otitis media with pure conductive hearing loss were posted for tympanoplasty. Temporalis fascia graft was used in 71 patients and cartilage perichondrium (composite graft) was used in 61 patients. Post operative healing, hearing and rate of retraction or reperforation was compared for both the graft materials. All the patients were followed up for 2 years. Patients where temporalis fascia graft was used, 60 (84.5%) showed a good neotympanum, 7(9.85%) had reperforation and 5(7.04%) had retraction pockets. Patients where tragal cartilage perichondrium was used, 60(98.36%) showed a healed tympanic membrane and only 1(1.63%) had reperforation. None of the patients showed retraction pocket or cholestetoma. Postoperative hearing was accessed 6 months after surgery. Patients with temporalis fascia graft showed an air bone gap of less than 10 dB in 49 (82%) patients and more than 10 dB in 11 (18%) patients. Air bone gap closure with tragal cartilage perichondrium was less than 10 dB in 45 (78%) patients and more than 10 dB in 13 patients (22%). Tragal cartilage perichondrium (\0.5 mm) seems to be an ideal graft material for tympanic membrane in terms of postoperative healing and acoustic properties. It can easily withstand negative middle ear pressure which may have contributed to the development of otitis media and significantly affect healing outcomes in postoperative period. Tragal cartilage being composed of collagen type II is also physiologically similar to the nature of the tympanic membrane.

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Section: Discussionmentioning

confidence: 99%

Cartilage–Perichondrium: An Ideal Graft Material?

Chhapola¹,

Matta²

2011

Indian J Otolaryngol Head Neck Surg

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“…When partial ossicular reconstruction prosthesis is required, results are worse, and they are canal wall status dependent (27). Recurrent disease seemed either in the attic or developed from a retraction pocket in a similar manner to patients receiving primary surgery.…”

Section: Discussionmentioning

confidence: 99%

Audiologic Results of Surgery for Cholesteatoma

Stanković

2008

Otology &Amp; Neurotology

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The audiologic results of cholesteatoma surgery are preserved during long-term follow-up. We found that recurrent cholesteatoma was associated with diminished postoperative hearing. Poorer preoperative hearing level, CWD tympanoplasty, younger age, bilateral cholesteatoma, and ossicular damage, as well as revision surgery, were associated with reduced gains in hearing with surgical management. Surgical experience was important for ICW technique and for advanced damage of auditory ossicles. Recurrent cholesteatoma resulted in significantly worse hearing results for each analyzed parameter.

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“…1 In the four studies presented here, 1,250 patients were treated with CWU procedures and 49 (3.9%) unexpected residual cholesteatomas were found. [1][2][3][4] Four hundred seventy-eight planned secondlook procedures were performed and 156 (32.6%) residual cholesteatomas were found. Therefore, more than 67% of the second-look procedures were unnecessary.…”

Section: Discussionmentioning

confidence: 99%

“…In 2006, Kaylie et al looked at 470 procedures for cholesteatoma 2 and evaluated residual disease and recurrent disease. They performed 183 CWU procedures for cholesteatoma and 287 CWD procedures, with a mean 4.1 years of follow-up.…”

Section: Literature Reviewmentioning

confidence: 99%