Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 4/2012

01-04-2012 | Otology

Audiological and graft take results of cartilage reinforcement tympanoplasty (a new technique) versus fascia

Authors: Arman Tek, Murat Karaman, Celil Uslu, Tülay Habeşoğlu, Yasin Kılıçarslan, Ruhi Durmuş, Senem Esen, Erol Egeli

Published in: European Archives of Oto-Rhino-Laryngology | Issue 4/2012

Login to get access

Abstract

Our objective is to compare hearing and graft take results of temporal muscle fascia tympanoplasty and cartilage reinforcement tympanoplasty. Seventy seven patients are classified into two groups: Group 1 included 37 patients for whom cartilage graft, harvested from symba concha, is used as reinforcement under temporalis muscle fascia anteriorly and Group 2 included 40 patients for whom only temporalis muscle fascia is used in type 1 tympanoplasty. A pure-tone audiometry is done within 1 week prior to surgery and at 6 months postoperatively. There is statistically significant difference between postoperative graft take results among groups. In both groups postoperative anterior TM perforation is encountered most commonly. Success rate of cartilage reinforcement tympanoplasty in revision patients is 100% but temporal muscle fascia tympanoplasty’s is 66%. There is no statistically significant difference between preoperative and postoperative air conduction gain of TM intact patients. The results indicated that Cartilage reinforcement myringoplasty technique under anterior of the temporal muscle fascia significantly increases the graft take ratios in high-risk perforations and it also does not affect hearing levels. Therefore, the authors suggest usage of cartilage reinforcement tympanoplasty technique under anterior of the temporal muscle fascia which is an easy and applicable technique to increase graft take ratios, particularly in patients with preoperative anterior and subtotal TM perforations.
Literature
1.
go back to reference Shambaugh GE (1990) Closure of tympanic membrane perforations. In: Glasscock ME III, Shambaugh GE (eds) Surgery of the ear, 4th edn. W. B. Saunders, Philadelphia, pp 334–348 Shambaugh GE (1990) Closure of tympanic membrane perforations. In: Glasscock ME III, Shambaugh GE (eds) Surgery of the ear, 4th edn. W. B. Saunders, Philadelphia, pp 334–348
2.
go back to reference Gerber MJ, Mason JC, Lampert PR (2000) Hearing results after primary cartilage tympanoplasty. Laryngoscope 110(12):1994–1999PubMedCrossRef Gerber MJ, Mason JC, Lampert PR (2000) Hearing results after primary cartilage tympanoplasty. Laryngoscope 110(12):1994–1999PubMedCrossRef
3.
4.
go back to reference Mills RP (1997) Management of chronic suppurative otitis media. In: Booth JB, Kerr AG (eds) Scott-Brown’s Otolaryngology, 6th edn. Oxford: Butterworth-Heinemann International Editions, p 3/10/3–5 Mills RP (1997) Management of chronic suppurative otitis media. In: Booth JB, Kerr AG (eds) Scott-Brown’s Otolaryngology, 6th edn. Oxford: Butterworth-Heinemann International Editions, p 3/10/3–5
5.
go back to reference Levinson RM (1987) Cartilage–perichondrial composite graft tympanoplasty in the treatment of posterior marginal and attic retraction pockets. Laryngoscope 97:1069–1074PubMedCrossRef Levinson RM (1987) Cartilage–perichondrial composite graft tympanoplasty in the treatment of posterior marginal and attic retraction pockets. Laryngoscope 97:1069–1074PubMedCrossRef
6.
go back to reference Kerr AG, Byrene JET, Smyth GDL (1973) Cartilage homografts in the middle ear: a long term histologic study. J Laryngol Otol 87:1193–1199PubMed Kerr AG, Byrene JET, Smyth GDL (1973) Cartilage homografts in the middle ear: a long term histologic study. J Laryngol Otol 87:1193–1199PubMed
7.
go back to reference Buckingham RA (1992) Fascia and perichondrium atrophy in tympanoplasty and recurrent middle ear atelectasis. Ann Otol Rhinol Laryngol 101:755–758PubMed Buckingham RA (1992) Fascia and perichondrium atrophy in tympanoplasty and recurrent middle ear atelectasis. Ann Otol Rhinol Laryngol 101:755–758PubMed
8.
go back to reference Utech H (1959) Uber diagnostische und therapeutische Möglichkeiten der Tympanotomie bei Schalleitungsstörungen. Ztschr Laryng Rhinol Otol 38:212–221 Utech H (1959) Uber diagnostische und therapeutische Möglichkeiten der Tympanotomie bei Schalleitungsstörungen. Ztschr Laryng Rhinol Otol 38:212–221
9.
go back to reference Heermann J (1962) Erfahrungen mit frei transplantierten Faszien-Bind-egewebw des Musculus temporalis bei Tympanoplastik und Verkleinung der Radikalhöhle. Knorpelbrücke vom Stapes zum unteren Trommelfellrand. Ztschr Laryng Rhinol Otol 41:141–155 Heermann J (1962) Erfahrungen mit frei transplantierten Faszien-Bind-egewebw des Musculus temporalis bei Tympanoplastik und Verkleinung der Radikalhöhle. Knorpelbrücke vom Stapes zum unteren Trommelfellrand. Ztschr Laryng Rhinol Otol 41:141–155
10.
go back to reference Indorewala S (2002) Dimensional stability of free fascia grafts: an animal experiment. Laryngoscope 112(4):727–730PubMedCrossRef Indorewala S (2002) Dimensional stability of free fascia grafts: an animal experiment. Laryngoscope 112(4):727–730PubMedCrossRef
11.
go back to reference Duckert LG, Müller J, Makielski KH, Helms J (1995) Composite autograft “shield” reconstruction of remnant tympanic membranes. Am J Otol 16:21–26PubMed Duckert LG, Müller J, Makielski KH, Helms J (1995) Composite autograft “shield” reconstruction of remnant tympanic membranes. Am J Otol 16:21–26PubMed
12.
go back to reference Kirazli T, Bilgen C, Midilli R, Öğüt F (2005) Hearing results after primary cartilage tympanoplasty with island technique. Otolaryngol Head Neck Surg 132:933–937PubMedCrossRef Kirazli T, Bilgen C, Midilli R, Öğüt F (2005) Hearing results after primary cartilage tympanoplasty with island technique. Otolaryngol Head Neck Surg 132:933–937PubMedCrossRef
13.
go back to reference Gamra OB, Mbarek C, Khammassi K, Methlouthi N et al (2008) Cartilage graft in type 1 tympanoplasty: audiological and otological outcome. Eur Arch Otorhinolaryngol 265:739–742PubMedCrossRef Gamra OB, Mbarek C, Khammassi K, Methlouthi N et al (2008) Cartilage graft in type 1 tympanoplasty: audiological and otological outcome. Eur Arch Otorhinolaryngol 265:739–742PubMedCrossRef
14.
go back to reference Tos M (2008) Cartilage tympanoplasty methods: proposal of a classification. Otolaryngol Head Neck Surgery 139:747–758CrossRef Tos M (2008) Cartilage tympanoplasty methods: proposal of a classification. Otolaryngol Head Neck Surgery 139:747–758CrossRef
15.
go back to reference Saraç S (2005) Anteriorda Kikirdak ile Güçlendirilmiş Timpanoplasti. In: Önerci M (ed) Kulak Burun Boğaz Baş Boyun Cerrahi’sinde Güncel Yaklaşim, 1st ed Hacettepe Üniversitesi Hastaneleri Basimevi, Aralik, 1(4):44–45 Saraç S (2005) Anteriorda Kikirdak ile Güçlendirilmiş Timpanoplasti. In: Önerci M (ed) Kulak Burun Boğaz Baş Boyun Cerrahi’sinde Güncel Yaklaşim, 1st ed Hacettepe Üniversitesi Hastaneleri Basimevi, Aralik, 1(4):44–45
17.
go back to reference Dornhoffer J (2004) Cartilage tympanoplasty: indications, techniques and outcomes in a 1,000 patient series. Laryngoscope 113:1844–1856CrossRef Dornhoffer J (2004) Cartilage tympanoplasty: indications, techniques and outcomes in a 1,000 patient series. Laryngoscope 113:1844–1856CrossRef
18.
go back to reference Dornhoffer J (2006) Cartilage tympanoplasty. Otolaryngol Clin N Am 39:1161–1176CrossRef Dornhoffer J (2006) Cartilage tympanoplasty. Otolaryngol Clin N Am 39:1161–1176CrossRef
19.
go back to reference Glasscock ME, Jackson CG, Nissen AJ (1982) Schwaber MK. Postauricular undersurface tympanic membrane grafting: a follow-up report Laryngoscope 92:718–727 Glasscock ME, Jackson CG, Nissen AJ (1982) Schwaber MK. Postauricular undersurface tympanic membrane grafting: a follow-up report Laryngoscope 92:718–727
20.
go back to reference Milewski C (1993) Composite graft tympanoplasty in the treatment of ears with advanced middle ear pathology. Laryngoscope 103:1352–1356PubMedCrossRef Milewski C (1993) Composite graft tympanoplasty in the treatment of ears with advanced middle ear pathology. Laryngoscope 103:1352–1356PubMedCrossRef
21.
go back to reference Yu L, Han C, Yu H, Yu D (2001) Auricular cartilage palisade technique for repairing tympanic membrane perforation. Zhoughau Er Bi Yan Hou Ke Za Zhi 36(3):166–168 Yu L, Han C, Yu H, Yu D (2001) Auricular cartilage palisade technique for repairing tympanic membrane perforation. Zhoughau Er Bi Yan Hou Ke Za Zhi 36(3):166–168
22.
go back to reference Singh M, Rai A, Bandypadhyay S, Gupta SC (2003) Comparative study of the underlay and overlay techniques of myringoplasty in large and subtotal perforations of the tympanic membrane. J Laryngol Otol 117:444–448PubMedCrossRef Singh M, Rai A, Bandypadhyay S, Gupta SC (2003) Comparative study of the underlay and overlay techniques of myringoplasty in large and subtotal perforations of the tympanic membrane. J Laryngol Otol 117:444–448PubMedCrossRef
23.
go back to reference Fisch U. Timpanoplasti, Mastoidektomi ve Stapez Cerrahisi. Georg Thieme Verlag- Nobel Tip Kitapevleri 1996, sayfa 39 Fisch U. Timpanoplasti, Mastoidektomi ve Stapez Cerrahisi. Georg Thieme Verlag- Nobel Tip Kitapevleri 1996, sayfa 39
24.
go back to reference Kazikdas CK, Onal K, Boyraz I, Karabulut E (2007) Palisade cartilage tympanoplasty for management of subtotal perforations: a comparison with the temporalis fascia technique. Eur Arch Otorhinolaryngol 264:985–989PubMedCrossRef Kazikdas CK, Onal K, Boyraz I, Karabulut E (2007) Palisade cartilage tympanoplasty for management of subtotal perforations: a comparison with the temporalis fascia technique. Eur Arch Otorhinolaryngol 264:985–989PubMedCrossRef
25.
go back to reference Blanshard JD, Robson AK, Smith I, Maw AR (1990) A long term view of myringoplasty in children. J Laryngol Otol 104:758–762PubMedCrossRef Blanshard JD, Robson AK, Smith I, Maw AR (1990) A long term view of myringoplasty in children. J Laryngol Otol 104:758–762PubMedCrossRef
26.
go back to reference Halik JJ, Smyth GDL (1998) Long term results of tympanic membrane repair. Otolaryngol Head Neck Surg 98:162–169 Halik JJ, Smyth GDL (1998) Long term results of tympanic membrane repair. Otolaryngol Head Neck Surg 98:162–169
27.
go back to reference Hough JVD (1982) Experience in tympanoplasty—avoiding revision and complications. Otolaryngol Am 15:845–860 Hough JVD (1982) Experience in tympanoplasty—avoiding revision and complications. Otolaryngol Am 15:845–860
28.
go back to reference Poe DS, Gadre AK (1993) Cartilage tympanoplasty for management of retraction pockets and cholesteatomas. Laryngoscope 103:614–618PubMedCrossRef Poe DS, Gadre AK (1993) Cartilage tympanoplasty for management of retraction pockets and cholesteatomas. Laryngoscope 103:614–618PubMedCrossRef
29.
go back to reference Amedee RG, Mann WJ, Riechelmann H (1989) Cartilage palisade tympanoplasty. Am J Otol 10:447–450PubMed Amedee RG, Mann WJ, Riechelmann H (1989) Cartilage palisade tympanoplasty. Am J Otol 10:447–450PubMed
30.
go back to reference Eviatar A (1978) Tragal perichondrium and cartilagae in reconstructive ear surgery. Laryngoscope 88 (8 Pt 2 Suppl) 11:1–23 Eviatar A (1978) Tragal perichondrium and cartilagae in reconstructive ear surgery. Laryngoscope 88 (8 Pt 2 Suppl) 11:1–23
Metadata
Title
Audiological and graft take results of cartilage reinforcement tympanoplasty (a new technique) versus fascia
Authors
Arman Tek
Murat Karaman
Celil Uslu
Tülay Habeşoğlu
Yasin Kılıçarslan
Ruhi Durmuş
Senem Esen
Erol Egeli
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
European Archives of Oto-Rhino-Laryngology / Issue 4/2012
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-011-1779-4

Other articles of this Issue 4/2012

European Archives of Oto-Rhino-Laryngology 4/2012 Go to the issue