The fibrous annulus in myringoplasty

Abstract

Graft cholesteatoma is a serious complication of tympanic membrane grafting. It is due to burying keratinizing epithelium under the graft. Its occurrence in the anterior angle has been attributed to the presence of epithelial rests within the annulus in this area, and consequently is considered inevitable with overlay technique.In the present study we propose that this complication is due to inadequate surgical technique rather than due to factors inherent in underlying pathology or in the technique itself.

Hyaluronic acid fat graft myringoplasty: A minimally invasive technique

“…Small epithelial pearl on the TM or ''drum cholesteatoma'' is 50% less frequent than what it is reported for the overlay technique. 24 To prevent drum cholesteatoma in HAFGM, we should pay specific attention to cleaning the perforation rim from any medial epithelial migration. TM blunting or lateralization did not occur in any case of our HAFGM series.…”

Outcomes of the overlay graft technique in tympanoplasty

“…Sheehy and Glasscock first described the overlay graft technique that is the focus of this study in 1967 4 . It has been suggested that overlay graft placement is a superior technique as it provides a broader support for the graft, avoids compromise of the middle ear space, allows for better blood supply to the graft, is suitable for all sizes of perforation and gives better graft take results 4,5 . Removal of the anterior bony overhang with canalplasty and detailed inspection of the middle ear are routine aspects of the overlay procedure.…”

“…Removal of the anterior bony overhang with canalplasty and detailed inspection of the middle ear are routine aspects of the overlay procedure. This ensures adequate exposure and eradication of all disease at the time of surgery 5–7 . An incision in the fascia allows the graft to be placed medial to the malleus, preventing lateralization 2,7,8 .…”

“…Problems seen with the overlay technique include lateralization, anterior blunting and epithelial pearls. Many authors feel that with careful attention to detail and meticulous surgical technique, these problems can be avoided 2,5,7,9 …”

Stent fracture following stenting of a myocardial bridge: Report of two cases

“…Complications of HAFGM are minimal. Small epithelial pearl on the TM or “drum cholesteatoma” is 50% less frequent than what it is reported for the overlay technique 24. To prevent drum cholesteatoma in HAFGM, we should pay specific attention to cleaning the perforation rim from any medial epithelial migration.…”