Transcanal Endoscopic Cartilage and Perichondrium Graft Myringoplasty for Large Tympanic Membrane Perforations

Lou, Zhengcai

doi:10.1097/mao.0000000000003141

Cited by 11 publications

(3 citation statements)

References 31 publications

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“…Previous study suggested that the perichondrium overlaying the epithelial layer of double layer graft and everted edges of traumatic perforation didn't induce the iatrogenic cholesteatoma. [21][22][23] On the contrary, the pearl formations were found in 5.3% patients even if the perforation margins and the squamous epithelium of TM remnant were removed completely in interlay myringoplasty with anterior subannular grafting technique for anterior and subtotal perforations. 13 In this study, 72.3% patients completed 3 years followup and performed temporal bone CT examination, CT revealed the well pneumatization of mastoids and middle ear.…”

Section: Discussionmentioning

confidence: 98%

Endoscopic Perichondrium-Cartilage Myringoplasty With Preserving of Anterior Margins and Tuck Grafts for Repairing Anterior Perforation With 3 year Followup

Liu,

Wei,

Ding

et al. 2023

Ann Otol Rhinol Laryngol

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Objective: The objective of this study was to evaluate the graft outcomes of endoscopic perichondrium-cartilage myringoplasty with preserving of anterior margins for repairing anterior perforation with 3 year followup. Study design: Prospective case series. Setting: Tertiary university hospital. Materials and Methods: We performed a prospective study in 47 patients with anterior perforation who underwent perichondrium-cartilage myringoplasty with preserving of anterior margins and tuck grafts. The operation time, graft success rate, hearing outcome, and complications were evaluated at 6 months and 3 years after surgery. Results: A total of 47 ears with anterior marginal perforation were included in the study. The perforation size was subtotal in 2 (4.3%) eras, large in 11 (23.4%) ears, medium in 27 (57.4%) ears, and small in 7 (14.9%). The mean operation time was 41.2 ± 5.4 minutes. All patients completed 6 months of follow-up. Residual perforation was observed in 2 patients with medium perforations, the graft success rate was 95.7% (45/47). The mean preoperative and postoperative AC PTAs were 38.1 ± 7.3 dB and 25.4 ± 4.6 dB ( P < .05), while the mean preoperative and postoperative BC PTAs were 9.0 ± 4.6 dB and 9.6 ± 1.9 dB ( P = .672). The functional success was 91.5% (43/47). None of the patients reported sensorineural hearing loss, altered taste, facial nerve palsy, vertigo, or tinnitus during the follow-up period. In addition, 34 (72.3%) patients completed 3 years followup and performed temporal bone CT examination, the mean followup time was 39.1 ± 2.7 months, CT revealed the well pneumatization of mastoids and middle ear. Conclusions: Endoscopic perichondrium-cartilage myringoplasty with preserving of anterior margins and tuck grafts is a safe, suitable, and reliable method for repair of anterior perforation with few risk of anterior blunting and lateralization.

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Section: Discussionmentioning

confidence: 98%

Endoscopic Perichondrium-Cartilage Myringoplasty With Preserving of Anterior Margins and Tuck Grafts for Repairing Anterior Perforation With 3 year Followup

Liu,

Wei,

Ding

et al. 2023

Ann Otol Rhinol Laryngol

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“…However, Ahmed et al 17 performed chondroperichondrial clip myringoplasty by directly spreading the overlying perichondrium over the superficial surface of the tympanic membrane and did not observe any middle-ear cholesteatoma during a follow-up period of 12-26 months. Lou and colleagues 18,19 applied the cartilage and perichondrium double-layer graft technique without removing the superficial epithelium to repair large perforations, and found no middle-ear cholesteatoma over a follow-up period of 28.2 ± 6.1 months. However, other groups reported middle-ear cholesteatoma following application of the underlay technique.…”

Section: Discussionmentioning

confidence: 99%

Comparison of perichondrium-cartilage button technique and traditional over-underlay technique for repairing large perforations

Sun¹

2023

J. Laryngol. Otol.

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Objective This study was performed to compare the operation time, graft outcomes and complications between the endoscopic cartilage-perichondrium button technique and over-under technique for repairing large perforations. Methods A total of 52 chronic large perforations were randomly allocated to receive treatment using the endoscopic cartilage-perichondrium button technique (n = 26) or over-under technique (n = 26). The graft outcomes, mean operation time and post-operative complications were compared between the two groups at 12 months. Results The study population consisted of 52 patients with unilateral chronic large perforations. All patients completed 12 months of follow up. The mean operation time was 32.3 ± 4.2 minutes in the button technique group and 51.6 ± 2.8 minutes in the over-underlay technique group (p < 0.01). The graft success rate at 12 months was 92.3 per cent (24 out of 26) in the button technique group and 96.2 per cent (25 out of 26) in the over-underlay group (p = 0.552). Conclusion The endoscopic cartilage-perichondrium button technique had similar graft success rates and hearing outcomes for large chronic perforations to the over-under technique, but significantly shortened the mean operation time.

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“…The recent bibliography specifies the interest of the new endoscopic approach, particularly in the repair of large perforations; transcanal endoscopic myringoplasty for large tympanic membrane perforations using a double-layer perichondrium and cartilage graft is feasible with comparable rates of closure to more invasive approaches [ 24 ]. And new other therapeutic methods have been published with the aim to improve therapeutic results in the repair of eardrum perforations such as the use of cartilage-perichondrium double graft combined with basic fibroblast growth factor, which has been demonstrated as effective method for providing the long-term graft success rate of the perforations with extensive epithelialization [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Cartilage Graft in Myringoplasty: What Are the Factors Influencing Hearing Gain?

et al. 2022

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Background and Objectives:We present the anatomical and functional results on the use of cartilage in myringoplasty and use the data to analyze the factors influencing hearing gain. Subjects and Methods: This retrospective study included 161 cases of cartilage myringoplasties collected over an 11-year period (2010-2020). Of the 161 cases, the etiology of the tympanic perforations was simple chronic otitis media in 154 (95.65%) ears and traumatic in 7 (4.35%) ears. The mean preoperative Rinne was 26.20±7.05 dB. The most commonly used approach was retroauricular, and the common graft material was tragal or conqual cartilage. Results: After the follow-up period (mean:15 months), the anatomical success rate was 93.2%; there were nine cases of reperforation, of which three were reoperated with a good final result. The hearing success rate (residual Rinne ≤20 dB) was 91.9% with an average gain of 11.48 ± 8.62 dB. The only factor significantly influencing the anatomical outcome was the history of chronic rhinosinusitis. In univariate studies, several factors influencing the functional result were revealed; the only one retained after elimination of bias was the anatomical result. Conclusions: We recommend cartilage as the material of choice for myringoplasties as it has been shown to be resistant to predictive factors of failure after tympanic repair surgery. We recommend the adequate management of all chronic rhinosinusitis before performing myringoplasty.

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Transcanal Endoscopic Cartilage and Perichondrium Graft Myringoplasty for Large Tympanic Membrane Perforations

Abstract: Supplemental Digital Content is available in the text

Cited by 11 publications

References 31 publications

Endoscopic Perichondrium-Cartilage Myringoplasty With Preserving of Anterior Margins and Tuck Grafts for Repairing Anterior Perforation With 3 year Followup

Endoscopic Perichondrium-Cartilage Myringoplasty With Preserving of Anterior Margins and Tuck Grafts for Repairing Anterior Perforation With 3 year Followup

Comparison of perichondrium-cartilage button technique and traditional over-underlay technique for repairing large perforations

Cartilage Graft in Myringoplasty: What Are the Factors Influencing Hearing Gain?

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