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European Archives of Oto-Rhino-Laryngology

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01-11-2013 | Review Article

Is cartilage better than temporalis muscle fascia in type I tympanoplasty? Implications for current surgical practice

Authors: Emily Iacovou, Petros V. Vlastarakos, George Papacharalampous, Efthymios Kyrodimos, Thomas P. Nikolopoulos

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2013

Abstract

The aim of this study was to compare the hearing results and graft integration rates in patients undergoing myringoplasty for the reconstruction of the tympanic membrane, with the use of either cartilage or temporalis muscle fascia (TMF). A systematic literature review in Medline and other database sources up to February 2012 was carried out, and the pooled data were meta-analyzed. Twelve studies were systematically analyzed. One represented level I, one level II and ten level III evidence. The total number of treated patients was 1,286. Cartilage reconstruction was used in 536, TMF in 750 cases. Two level III studies showed a significant difference between the pre- and postoperative air-bone gap closure, in favor of cartilage grafting. The mean graft integration rate was 92.4 % in the cartilage group and 84.3 % in the TMF group (p < 0.05). The rates of re-perforations were 7.6 and 15.5 %, respectively (p < 0.05). Among the other complications of type I tympanoplasty, retraction pockets, otitis media with effusion, anterior blunting, and graft lateralization were usually surgically managed, whereas most of the rest were minor and could be dealt with conservatively. The graft integration rate in myringoplasty is higher after using cartilage, in comparison with fascia reconstructions (grade C strength of recommendation), and the rate of re-perforation is significantly lower. Although cartilage is primarily used as grafting material in cases of Eustachian tube dysfunction, adhesive otitis media, and subtotal perforation in everyday surgical practice, a wider utilization for the reconstruction of the tympanic membrane in myringoplasties can be recommended.

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Title: Is cartilage better than temporalis muscle fascia in type I tympanoplasty? Implications for current surgical practice
Authors: Emily Iacovou
Petros V. Vlastarakos
George Papacharalampous
Efthymios Kyrodimos
Thomas P. Nikolopoulos
Publication date: 01-11-2013
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 11/2013
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-012-2329-4

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Is cartilage better than temporalis muscle fascia in type I tympanoplasty? Implications for current surgical practice

Abstract

Keynote webinar | Spotlight on sleep in brain health

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Abstract

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