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Cartilage graft in type I tympanoplasty: audiological and otological outcome

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Abstract

The aim of this study is to evaluate anatomical and audiological results of cartilage tympanoplasty compared to fascia tympanoplasty in the reconstruction of tympanic membrane perforations. We carry a retrospective study about 380 patients operated in our department between 1998 and 2005. Patients were classified into two groups: 90 (23.6%) undergo cartilage tympanoplasty and 290 (76.4%) fascia tympanoplasty. In each group, we calculated the average of pre and postoperative air bone gap (ABG) and the average air conduction gain (ACG) at 250–4,000 Hz. The surgical technique is explained in detail. We detail and analyze the audiological and anatomical results in each group. Successful closure of the tympanic membrane perforation was achieved in 97% of the cartilage group as compared to 94% of the fascia group. The average ACG was 21 ± 11 dB in cartilage group and 20 ± 22 dB in fascia group. With an average follow-up of 2 years, residual perforation was observed in 2.2% in cartilage group. Reperforation of fascia graft and retraction were noted in 2.1 and 1%, respectively. The authors show the great reliability of cartilage tympanoplasty to close tympanic membrane perforations. We recommend using cartilage as a first choice, especially in stable or evolutive chronic otitis media, and in recurrent perforation of the tympanic membrane.

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References

  1. Zoellner F (1955) The principles of plastic surgery of the sound-conducting apparatus. J Laryngol Otol 69:657–659

    Google Scholar 

  2. Wullstein HL (1952) Funktionelle Operationen im Mettelohr mit Hilfe des Freien Spaltlappentransplantates. Arch Otorhinolaryngol 161:422–435

    Google Scholar 

  3. Rizer FM (1997) Tympanoplasty: a historical review and a comparison of techniques. Laryngoscope 107(suppl 84):1–25

    Article  PubMed  CAS  Google Scholar 

  4. Dornhoffer J (1997) Hearing results with cartilage tympanoplasty. Laryngoscope 107:1094–1099

    Article  PubMed  CAS  Google Scholar 

  5. Gerber MJ, Mason JC, Lambert PR (2000) Hearing results after primary cartilage tympanoplasty. Laryngoscope 110:1994–1999

    Article  PubMed  CAS  Google Scholar 

  6. Buckingham RA (1992) Fascia and perichondrium atrophy in tympanoplasty and recurrent middle ear atelectasis. Ann Otol Rhinol Laryngol 101:755–758

    PubMed  CAS  Google Scholar 

  7. Milewski C (1993) Composite graft tympanoplasty in the treatment of ears with advanced middle ear pathology. Laryngoscope 103:1352–1356

    Article  PubMed  CAS  Google Scholar 

  8. Utech H (1959) Ueber diagnostische und therapeutische Moeglichkeiten der Tympanotomie bei Schalleitungsstoerungen. Laryngol Rhinol 38:212–221

    CAS  Google Scholar 

  9. Heermann J (1978) Auricular cartilage palisade tympano-, epitympano-, antrum- and mastoid-plasties. Clin Otolaryngol Allied Sci 3:443–446

    Article  PubMed  CAS  Google Scholar 

  10. Heermann J (1992) Autograft tragal and conchal palisade cartilage and perichondrium in tympanomastoid reconstruction. Ear Nose Throat J 71:344–349

    PubMed  CAS  Google Scholar 

  11. Glasscock ME, Jackson CG, Nissen AJ, Schwaber MK (1982) Post-auricular undersurface tympanic membrane grafting: a follow-up report. Laryngoscope 92:718–727

    Article  PubMed  Google Scholar 

  12. Levinson RM (1987) Cartilage-perichondrial composite graft tympanoplasty in the treatment of posterior marginal and attic retraction pockets. Laryngoscope 97:1069–1074

    Article  PubMed  CAS  Google Scholar 

  13. Adkins WY (1990) Composite autograft of tympanoplasty and tympanomastoid surgery. Laryngoscope 100:244–247

    Article  PubMed  CAS  Google Scholar 

  14. Amadee RG, Mann WJ, Riechelmann H (1989) Cartilage palisade tympanoplasty. Am J Otol 10:447–450

    Google Scholar 

  15. Duckert LG, Müller J, Makielski KH, Helms J (1995) Composite autograft ‘shield’ reconstruction of remnant tympanic membranes. Am J Otol 16:21–26

    PubMed  CAS  Google Scholar 

  16. Dornhoffer J (2003) Cartilage tympanoplasty: indications, techniques, and outcomes in a 1000-patient series. Laryngoscope 113:1844–1856

    Article  PubMed  Google Scholar 

  17. Eavey RD (1998) Inlay tympanoplasty: cartilage butterfly technique. Laryngoscope 108:657–661

    Article  PubMed  CAS  Google Scholar 

  18. Mauri M (2001) Evaluation of inlay butterfly cartilage tympanoplasty: a randomised clinical trial. Laryngoscope 11:1479–1485

    Article  Google Scholar 

  19. Hartwein J, Leuwer RM, Kehrl W (1992) The total reconstruction of the tympanic membrane by the ‘Crowncork’ technique. Am J Otolaryngol 13:172–175

    Article  PubMed  CAS  Google Scholar 

  20. Gérard JM, Decat M, Gersdorff M (2003) Tragal cartilage in tympanic membrane reconstruction. Acta Otorhinolaryngol Belg 57:147–150

    PubMed  Google Scholar 

  21. Puls T (2003) Tympanoplasty using conchal cartilage graft. Acta Otorhinolaryngol Belg 57:187–191

    PubMed  CAS  Google Scholar 

  22. Zahnert T, Huttenbrink KB, Murbe D, Bornitz M (2000) Experimental investigations of the use of cartilage in tympanic membrane reconstruction. Am J Otol 21:322–328

    Article  PubMed  CAS  Google Scholar 

  23. Hickx GW (1988) A review of 925 cases of tympanoplasties using formaldehyde-formed-fascia grafts. Laryngoscope 98:150–153

    Google Scholar 

  24. Claes J (1990) Allograft tympanoplasty: predictive value of preoperative status. Laryngoscope 100:1313–1318

    Article  PubMed  CAS  Google Scholar 

  25. Elasfour AA, Zaghloul HS (2003) Cartilage tympanoplasty: audiological and otological outcome. Int Congr Ser 1240:73–79

    Article  Google Scholar 

  26. Abou Mayaleh H, Heshiki R, Portmann D, Négrevergne M (2005) Reinforcing tympanoplasty with cartilage mosaic (differences from the palisade technique). Rev Laryngol Otol Rhinol 126:181–189

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, Habib Thameur Hospital, 8 Rue Ali Ben Ayed, Montfleury, 1008, Tunis, Tunisia

    O. Ben Gamra, C. Mbarek, K. Khammassi, N. Methlouthi, H. Ouni, I. Hariga, S. Zribi, J. Koubâa & A. El Khedim

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  1. O. Ben Gamra
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  2. C. Mbarek
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  3. K. Khammassi
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  4. N. Methlouthi
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  5. H. Ouni
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  6. I. Hariga
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  7. S. Zribi
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  8. J. Koubâa
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  9. A. El Khedim
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Correspondence to O. Ben Gamra.

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Ben Gamra, O., Mbarek, C., Khammassi, K. et al. Cartilage graft in type I tympanoplasty: audiological and otological outcome. Eur Arch Otorhinolaryngol 265, 739–742 (2008). https://doi.org/10.1007/s00405-008-0645-5

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  • DOI: https://doi.org/10.1007/s00405-008-0645-5

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