Palisade cartilage tympanoplasty compared to one-piece composite cartilage-perichondrium grafts for transcanal endoscopic treatment of subtotal tympanic membrane perforations: a retrospective study

A Commentary to this article is available

Abstract

Purpose

The endoscopic approach to tympanoplasty is gaining popularity, but its adoption for the palisade tympanoplasty technique is unstudied. The aim of the present study was to evaluate the effectiveness of endoscopic cartilage palisade tympanoplasty compared to one-piece composite cartilage-perichondrium grafts for tympanic membrane closure in adult patients with subtotal perforations.

Methods

Retrospective study of 42 adult patients who underwent endoscopic tympanoplasty for a subtotal perforation in a university tertiary referral center from January 2018 to June 2019. Patients underwent transcanal tympanoplasty either with cartilage palisade grafts or with one-piece composite cartilage-perichondrium grafts. Both techniques were compared for graft take rate and audiometric results.

Results

Twenty palisade and 22 single-piece tympanoplasties were analyzed. No statistically significant differences between groups were found in terms of tympanic membrane closure (85% vs. 86.3%, p = 0.5) or hearing improvement.

Conclusion

The results of the present study suggest that similar results can be obtained with palisade cartilage grafts compared to the one-piece composite cartilage-perichondrium technique for endoscopic tympanic membrane closure. Further studies with long-term results will be needed to confirm these findings.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF (2017) Comparison of the efficacy of endoscopic tympanoplasty and microscopic tympanoplasty: a systematic review and meta-analysis. Laryngoscope 127:1890–1896

    Article  Google Scholar 

  2. 2.

    Ayache S (2013) Cartilaginous myringoplasty: the endoscopic transcanal procedure. Eur Arch Otorhinolaryngol 270:853–860

    Article  Google Scholar 

  3. 3.

    Wuesthoff C, Hardman J, Saxby AJ, Jufas N, Patel N (2018) How I do it-endoscopic composite cartilage graft tympanoplasty. Aust J Otolaryngol 1:33. https://doi.org/10.21037/ajo.2018.11.03

    Article  Google Scholar 

  4. 4.

    Jalali MM et al (2017) Comparison of cartilage with temporalis fascia tympanoplasty: a meta-analysis of comparative studies. Laryngoscope 127:2139–2148

    Article  Google Scholar 

  5. 5.

    Bernal-Sprekelsen M, Romaguera Lliso MD, Sanz Gonzalo JJ (2003) Cartilage palisades in type III tympanoplasty: anatomic and functional long-term results. Otol Neurotol 24:38–42

    Article  Google Scholar 

  6. 6.

    Tos M (2009) Cartilage tympanoplasty. Thieme, Stuttgart, New York

    Google Scholar 

  7. 7.

    Jeffery CC, Shillington C, Andrews C, Ho A (2017) The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis. J Otolaryngol-Head Neck Surg 46:48. https://doi.org/10.1186/s40463-017-0225-z

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Kazikdas KC, 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 264:985–989

    Article  Google Scholar 

  9. 9.

    Dornhoffer J (2006) Cartilage tympanoplasty. Otolaryngol Clin North Am 39:1161–1176

    Article  Google Scholar 

  10. 10.

    Monsell E, Balkany T, Gates G, Goldenberg RA, Meyerhoff WL, House JW (1995) Committee on hearing and equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. Otolaryngol Head Neck Surg 113:186–187

    Article  Google Scholar 

  11. 11.

    Presutti L, Marchioni D (2014) Endoscopic ear surgery: principles, indications, and techniques. Thieme, Stuttgart

    Google Scholar 

  12. 12.

    Tos M (2008) Cartilage tympanoplasty methods: proposal of a classification. Otolaryngol Head Neck Surg 139:747–758

    Article  Google Scholar 

  13. 13.

    Balci MK, Islek A, Ciger E (2019) Does cartilage tympanoplasty impair hearing in patients with normal preoperative hearing? A comparison of different techniques. Eur Arch Otorhinolaryngol 276:673–677

    Article  Google Scholar 

  14. 14.

    Cabra J, Monux A (2010) Efficacy of cartilage palisade tympanoplasty: randomized controlled trial. Otol Neurotol 31:589–595

    Article  Google Scholar 

  15. 15.

    Mohamad SH, Khan I, Hussain SS (2012) Is cartilage tympanoplasty more effective than fascia tympanoplasty? A systematic review. Otol Neurotol 33:699–705

    Article  Google Scholar 

  16. 16.

    Marchioni D, Gazzini L, De Rossi S, Di Maro F, Sacchetto L, Carner M, Bianconi L (2020) The management of tympanic membrane perforation with endoscopic type I tympanoplasty. Otol Neurotol 41:214–221. https://doi.org/10.1097/MAO.0000000000002465

    Article  PubMed  Google Scholar 

  17. 17.

    Anschuetz L, Bonali M, Guarino P, Fabbri FB, Alicandri-Ciufelli M, Villari D, Caversaccio M, Presutti L (2017) Management of bleeding in exclusive endoscopic ear surgery: pilot clinical experience. Otolaryngol Head Neck Surg 157:700–706. https://doi.org/10.1177/0194599817726982

    Article  PubMed  Google Scholar 

Download references

Funding

None declared.

Author information

Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by JTO, and MJD. The first draft of the manuscript was written by FL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Francisco Larrosa.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee of Hospital Clinic de Barcelona (Reference No. HCB/2019/1101).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Larrosa, F., de Osso, J.T., Dura, M.J. et al. Palisade cartilage tympanoplasty compared to one-piece composite cartilage-perichondrium grafts for transcanal endoscopic treatment of subtotal tympanic membrane perforations: a retrospective study. Eur Arch Otorhinolaryngol 277, 1955–1959 (2020). https://doi.org/10.1007/s00405-020-05947-3

Download citation

Keywords

  • Endoscopic ear surgery
  • Tympanoplasty
  • Grafts
  • Cartilage palisade tympanoplasty
  • One-piece composite cartilage