Abstract
To evaluate graft take up and hearing improvement using the technique of tragal cartilage island in COM-mucosal type. Prospective study. A total of 258 type 1 tympanoplasty surgeries were done using tragal cartilage island graft from December 2013, to December 2015; in Jubilee Mission Medical College and Research Institute with a follow up of 1 year. Inclusion criteria—all the patients undergoing type 1 tympanoplasty for chronic otitis media (mucosal type, inactive) with an intact ossicular chain by the senior author. The youngest patient was 6 years old and the oldest was 64 years. This pattern was selected for getting a uniform pattern even though cartilage tympanoplasty can be done in other forms of COM also. Graft take up in our study was found to be 96.12% in 1 year of follow up. Closure of tympanic membrane was achieved in 248 of 258 cases. None of the patients showed retraction pockets or cholesteatoma during follow up. The average pre-op AB gap was 21.62 dB which was lowered to 4.22 dB post op. The mean gain in hearing was 17.37 dB. It is worthwhile to consider tragal cartilage island graft as an alternative to temporalis fascia.
Similar content being viewed by others
References
De Freitas MR, De Oliveira TC (2014) The role of different types of grafts in tympanoplasty. Braz J Otorhinolaryngol 80:275–276
Dornhoffer J (2003) Cartilage tympanoplasty: indications, techniques, and outcomes in A 1,000-patient series. Laryngoscope 113(11):1844–1856
De Seta E et al (2010) Cartilage tympanoplasty: how to reduce surgery time. J Laryngol Otol 124(7):784–785
Kevin Ho K-H, Katzenmeyer K(1999) TITLE: Tympanoplasty SOURCE: grand rounds presentation. The University of Texas Medical Branch in Galveston, Department of Otolaryngology DATE: June 9, 1999
Cavaliere M et al (2009) Tragal cartilage in tympanoplasty: anatomic and functional results in 306 cases. Acta Otorhinolaryngol Ital 29(1):27
Onal K et al (2012) Functional results of temporalis fascia versus cartilage tympanoplasty in patients with bilateral chronic otitis media. J Laryngol Otol 126(1):22–25
Aidonis I, Robertson TC, Sismanis AS (2005) Cartilage shield tympanoplasty: a reliable technique. Otol Neurotol 26(5):838–841
Tek A et al (2012) Audiological and graft take results of cartilage reinforcement tympanoplasty (a new technique) versus fascia. Eur Arch Oto-Rhino-Laryngol 269(4):1117–1126
Coelho DH et al (2012) Cartilage tympanoplasty in smokers. Ann Otol Rhinol Laryngol 121(10):657–663
Ahmed S et al (2013) Chondroperichondrial clip myringoplasty: a new technique for closure of tympanic membrane perforations. J Laryngol Otol 127(6):562
Şahan M et al (2014) Factors affecting success and results of cartilage-perichondrium island graft in revision tympanoplasty. J Int Adv Otol 10(1):64
Ferekidis EA et al (2003) Chondrotympanoplasty: a modified technique of cartilage graft tympanoplasty. Med Sci Monit 9(2):CR73–CR78
Mohamad SH, Khan I, Hussain SSH (2012) Is cartilage tympanoplasty more effective than fascia tympanoplasty? A systematic review. Otol Neurotol 33(5):699–705
Khan MM, Parab SR (2011) Primary cartilage tympanoplasty: our technique and results. Am J Otolaryngol 32(5):381–387
Gün T et al (2017) A comparison of cartilage palisades and temporal fascia in type 1 tympanoplasty for bilateral tympanic membrane perforations in children. J Int Adv Otol 13(1):36–39
Kalcioglu MT, Firat Y, Selimoglu E (2009) Cartilage tympanoplasty with island technique: a comparison with the temporalis muscle fascia technique. J Int Adv Otol 5(1):45–50
Al Qahtani B et al (2015) Tympanometric patterns in patients undergoing cartilage tympanoplasty of 0.6 mm thickness. Indian J Otol 21(4):233
Pradeep P et al (2017) Indian J Otolaryngol 29(2):63–68
Priya K et al (2012) Evaluation of eustachian tube function in chronic suppurative otitis media (tubotympanic type) with reference to its treatment outcome. Indian J Otol 18(4):179
Anirban B (2002) Clinical audio-vestibulometry for otologists and neurologists, 3rd edn. Bhalani Publishing House, Mumbai, pp 56–60
Salén B (1967) Tympanic membrane grafts of full-thickness skin, fascia and cartilage with its perichondrium. An experimental and clinical investigation. Acta oto-laryngol 85(Suppl-244):1173–1176
Jansen C (1963) Cartilage island tympanoplasty. Laryngoscope 73:1288–1301
Heermann Joachim, Heermann Hans, Kopstein Ernest (1970) Fascia and cartilage palisade mtympanoplasty: nine years’ experience. Arch Otolaryngol 91(3):228–241
Goodhill V (1967) Tragal perichondrium and cartilage in tympanoplasty. Arch Otolaryngol. 85(5):480–491
Tos M (2008) Cartilage tympanoplasty methods: proposal of a classification. Otolaryngol Head Neck Surg 139(6):747–758
Lee C-F et al (2007) Optimal graft thickness for different sizes of tympanic membrane perforation in cartilage myringoplasty: a finite element analysis. Laryngoscope 117(4):725–730
Mathur NN, Manimaran V, Deka A (2017) Indian J Otolaryngol Head Neck Surg (abstract)
Demirpehlivan IA, Onal K, Arslanoglu S et al (2011) Comparison of different tympanic membrane reconstruction techniques in type I tympanoplasty. Eur Arch Otorhinolaryngol 268(3):471–474 (abstract)
Karaman E, Duman C, Isildak H (2010) Composite cartilage island grafts in type 1 tympanoplasty: audiological and otological outcomes. J Craniofac Surg 21(1):37–39 (abstract)
Onal K et al (2011) Perichondrium/cartilage island flap and temporalis muscle fascia in type I tympanoplasty. J Otolaryngol Head Neck Surg 40(4):295–299 (abstract)
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
There are no conflicts of interest.
Ethical Approval
This study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed Consent
Informed consent was taken from all the patients.
Rights and permissions
About this article
Cite this article
Varghese, G.M., Abdullah, P.H. & Sabu, N.J. Sutureless Tragal Cartilage Island Tympanoplasty: Our Experience. Indian J Otolaryngol Head Neck Surg 71 (Suppl 2), 1377–1382 (2019). https://doi.org/10.1007/s12070-018-1438-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-018-1438-9