Triple-c Cartilage Tympanoplasty: Case Series

Abstract

The triple-c cartilage tympanoplasty i.e. (composite chondroperichondrial clip) technique was devised by Fernandes in 2003. Objectives: The objective of our case series was to assess the success rate and efficacy of the triple-c cartilage tympanoplasty by transcanal approach. Study Design: A retrospective analysis of patients subjected to the technique was conducted. Methods: 20 cases who met the inclusion criteria were assessed by otomicroscopy and pure tone audiometry before and 2 months after the surgery. Results: All patients had complete take-up of the graft and a hearing improvement which was statistically significant. Conclusions: Thus the triple-c technique provides an effective method of closing nonmarginal perforations of the tympanic membrane.

Endoscopic Myringoplasty Versus Microscopic Myringoplasty in Tubotympanic CSOM: A Comparative Study of 120 Cases

“…All our patients underwent myringoplasty using temporalis fascia graft. There are several studies which suggest tragal cartilage and perichondrium graft placed as a butterfly fashion is equally efficient as a graft for myringoplasty during endoscopic technique [17,18]. Further studies are required using the autologous tragal chondro-perichondrial graft.…”

Composite chondro-perichondrial clip myringoplasty: our experience

“…This transfers the acoustic energy better than normal cartilage. 7 Studies by Gierek et al and Couloinger et al have proven that there is no significant hearing difference between the use of temporalis fascia and cartilage for myringoplasty. 25,26 The composite chondro-perichondrial -clip‖ myringoplasty using the tragal cartilage and transcanal approach has a lot of advantages such as its a minimally invasive surgery done transcanally with an endoscope, it can be done in less than 30 minutes duration, it has good postoperative results in the form of perforation closure and improvement in hearing and it is cost-effective as it can be done under local anaesthesia and there is reduced hospital stay.…”

“…There is very limited data regarding curling of the cartilage, four incisions of the perichondrium -the anti-curling incisions‖ have been described by Tos but a systematic study is still required to validate them. 7 Recent studies show no difference in hearing results between the full thickness and partial thickness grafts 7 . Also histomorphological studies of cartilage grafts of Hitari have shown that there is wide replacement of the chondrocytes by fibrous tissue and loss of lipid vacuoles over time which makes the cartilage graft more homogenous in nature.…”

“…6 Tragal cartilage with perichondrium fulfils all the required qualities of an ideal graft material namely low rejection rate, sufficient quantity, good tensile strength, conductive properties similar to that of tympanic membrane and easy availability. 7 Fernandes has described in his study that the composite chondroperichondrial clip prepared from the autologous tragal cartilage provides an excellent material for the myringoplasty to close non-marginal perforations of the tympanic membrane. 8 Our study was done in the same fashion of using the tragal cartilage and perichondrium for non-marginal perforations of the tympanic membrane and analyzes the graft uptake rate and the reduction of air-bone gap after surgery.…”

A comparative study of endoscopic and microscopic myringoplasty in a rural tertiary care teaching hospital

“…8 Although our entire patients underwent myringoplasty using temporalis fascia graft, there are many other studies where tragal cartilage and perichondrium grafts were used. 17,18 There has also been studied where only 0 degree scopes are used and other studies were 0, 30 and 70 degree scopes have been used. 1,5 We have used only 0 and 30 degree scopes for our procedure and it has given us the capability to negotiate the curvy external auditory canal.…”