Revision Tympanoplasty Utilizing Fossa Triangularis Cartilage

Moore, Gary F.

doi:10.1097/00005537-200209000-00003

Cited by 35 publications

(23 citation statements)

References 21 publications

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“…The advantages of cartilage is high mechanical stability and long lasting vitality ever years after surgery. The success rate of ''take up'' by using cartilage grafts is reported up to 100% [24][25][26][27][28][29][30]. In our study, all the patients were followed up for 2 years.…”

Section: Discussionmentioning

confidence: 84%

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: 84%

Cartilage–Perichondrium: An Ideal Graft Material?

Chhapola¹,

Matta²

2011

Indian J Otolaryngol Head Neck Surg

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“…Moore [2002] reported that the tragal sections were 1.016 mm in thickness on average. No obvious differences in thickness and density were found between the specimens (p 1 0.05).…”

Section: Resultsmentioning

confidence: 99%

Biomechanical Modeling and Design Optimization of Cartilage Myringoplasty Using Finite Element Analysis

Lee

Hsu²,

Chen³

et al. 2006

Audiol Neurotol

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The purpose of this study was to determine the acoustic transfer characteristics of cartilage for optimal cartilage myringoplasty. In order to do so, we developed a cartilage plate/tympanic membrane-coupled model using finite element analysis. Cartilage specimens of the tragus were obtained from fresh human cadavers, and the parameters of the tragus were determined by curve fitting and cross-calibration. A cartilage plate was used to repair an eardrum perforation, and the new coupled tympanic membrane-cartilage complex was loaded into our 3-dimensional biomechanical model of the middle ear for analysis. Our results show that first the β-damping value of the cartilage plate depends on frequency. The value of β damping was close to 3 × 10^–4 s at lower frequencies and 5 × 10^–6 s at higher frequencies. Secondly, reducing cartilage thickness leads to an improvement of its acoustic transfer qualities. From an acoustics point of view, the 0.1- to 0.2-mm cartilage plate seems to be most preferable with regard to tympanic membrane vibration. Furthermore, thicknesses of 0.2 mm at lower frequencies and 0.1 mm at higher frequencies were regarded as good compromises between sufficient mechanical stability and low acoustic transfer loss.

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“…This study shows that fosse triangularis cartilage gives 100% success rate. 5 Zahnert et al, had shown same audiological outcome for tragal and conchal cartilage graft for tympanic membrane reconstruction. 6 Kazikdas et al had shown maximum functional outcome when size of cartilage is reduced to thickness of 500 micrometer.…”

Section: Introductionmentioning

confidence: 85%

Overview of tympanoplasty techniques and results

Chavan

Ingole

Birajdar

2017

Int J Otorhinolaryngol Head Neck Surg

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<p>The objective of this article is to overview about the changing techniques of tympanoplasty surgery and increase in the anatomical and functional success rate of surgeries. Introduction of endoscope in ear surgeries is time saving. Endoscopes are helpful to access hidden areas which was difficult with the help of microscope such as facial recesses, sinus tympani, extension of posterior-superior retraction pockets, etc. Also various modifications done in the techniques of using graft material for tympanoplasty surgery are reviewed in terms of graft acceptance and improvement of hearing. Articles reviewed are research articles, original articles and review articles published in pub med indexed journals. Because of Newer techniques in ear surgeries, tympanoplasty is becoming day care surgery. Also newer techniques are with cosmetic view and gives maximum post-operative hearing using minimal instrumentation. Efforts are taken to review the tympanoplasty surgical technique and its results.</p><p> </p>

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Revision Tympanoplasty Utilizing Fossa Triangularis Cartilage

Cited by 35 publications

References 21 publications

Cartilage–Perichondrium: An Ideal Graft Material?

Cartilage–Perichondrium: An Ideal Graft Material?

Biomechanical Modeling and Design Optimization of Cartilage Myringoplasty Using Finite Element Analysis

Overview of tympanoplasty techniques and results

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