Reinforcement of Sliced Tragal Cartilage Perichondrium Composite Graft with Temporalis Fascia in Type I Tympanoplasty: Our Techniques and Results -

Authors

  • Mubarak M. Khan Department of Otorhinolaryngology, M.I.M.E.R. Medical College, Pune, India
  • Sapna R. Parab Department of Otorhinolaryngology, M.I.M.E.R. Medical College, Pune, India

DOI:

https://doi.org/10.12970/2308-7978.2013.01.01.11

Keywords:

 Sliced tragal Cartilage, Temporalis fascia, Functional results, Tympanoplasty.

Abstract

 In our otological practice, we prefer sliced tragal cartilage- perichondrium grafting for reconstruction of the tympanic membrane perforations. In an attempt to reduce residual and recurrent perforations in our series of cartilage tympanoplasty using sliced tragal cartilage perichondrium composite graft, we reinforce tragal cartilage with temporalis fascia in large perforations. Aim: The purpose of this study is to evaluate anatomical and audiological results after primary cartilage tympanoplasty using sliced tragal cartilage reinforced with temporalis fascia in large perforations. Methods and Materials:We carried a prospective study of 28 patients operated from March 2010 to January 2011 in M.I.M.E.R Medical College and Sushrut ENT Hospital using sliced tragal cartilage reinforced with temporalis fascia. The surgical technique is described in detail. Results:Successful closure of the tympanic membrane was achieved in all patients at 2 years of follow up. The average postoperative Air Bone Gap was 9.6429+/-2.6557 dB. Conclusion: Reinforcement of temporalis fascia with sliced tragal cartilage is a reliable technique for tympanoplasty, especially in large perforations. To our knowledge, this is the first study involving the reinforcement of sliced tragal cartilage with temporalis fascia in type I tympanoplasty. 

References


[1] Albirmawy OA. Comparison between cartilage– perichondrium composite ‘ring’ graft and temporalis fascia in type one tympanoplasty in children. J Laryngol Amp Otol 2010; 124: 967-74. http://dx.doi.org/10.1017/S0022215110000885
[2] Zoellner F. The principles of plastic surgery of the sound conducting apparatus. J Laryngol Otol 1955; 69: 657-9.
[3] Wullstein HL. Functional operations in the middle ear with split-thickness skin graft
[inGerman]. Arch Otorhinolaryngol 1952; 161: 422-35. http://dx.doi.org/10.1007/BF02129204
[4] Rizer FM. Overlay versus underlay tympanoplasty. Part I: historical review of the literature. Laryngoscope 1997; 107: 1- 25. http://dx.doi.org/10.1097/00005537-199712001-00001
[5] Kerr AG, Byrne JET, Smyth GDL. Cartilage homografts in the middle ear: a long-term histologic study. J Laryngol Otol 1973; 87: 1193-99. http://dx.doi.org/10.1017/S0022215100078166
[6] Tos M. Cartilage tympanoplasty methods: proposal of a classification. Otolaryngol Head Neck Surg 2008; 136: 747- 58.
[7] Yung M. Cartilage tympanoplasty: literature review. J Laryngol Otol 2008; 122: 663-72.
[8] Khan MM, Parab SR. Primary cartilage tympanoplasty: our technique and results. Am J Otolaryngol 2011; 32(5): 381-7. http://dx.doi.org/10.1016/j.amjoto.2010.07.010
[9] Utech H. Ueber diagnostische und therapeutische Moeglichkeiten der Tympanotomie bei Schalleitungsstoerungen. Laryngol Rhinol 1959; 38: 212-21.
[10] Heermann J. Auricular cartilage palisade tympano-, epitympano-, antrum- and mastoid-plasties. Clin Otolaryngol Allied Sci 1978; 3: 443-46. http://dx.doi.org/10.1111/j.1365-2273.1978.tb00726.x
[11] Heermann J Autograft tragal and conchal palisade cartilage and perichondrium in tympanomastoid reconstruction. Ear Nose Throat J 1992; 71: 344-49.
[12] Saraç S. Anteriorda Kıkırdak ile Güçlendirilmis¸ Timpanoplasti. In: Önerci M, editor. Kulak Burun Bo_gaz Bas¸ Boyun Cerrahi’sinde Güncel Yaklas¸ım,1st edn. Aralık: Hacettepe Üniversitesi Hastaneleri Basımevi 2005; pp. 44-5.
[13] Uslu C, Tek A, Tatlipinar A, Carslan YK, Ruhi DS, Ayö_Gredik E, et al. Cartilage reinforcement tympanoplasty: otological and audiological results. Acta Oto-Laryngologica 2010; 130: 375-83. http://dx.doi.org/10.3109/00016480903145346
[14] Onal K, Uguz MZ, Kazikdas KC, Gursoy ST, Gokce H. A multivariate analysis of otological, surgical and patient related factors in determining success in myringoplasty. Clin Otolaryngol 2005; 30: 115-20. http://dx.doi.org/10.1111/j.1365-2273.2004.00947.x
[15] Ozbek C, Ciftçi O, Tuna EE, Yazkan O, Ozdem C. A comparison of cartilage palisades and fascia in type 1 tympanoplasty in children: anatomic and functional results. Otol Neurotol 2008; 29(5): 679-83. http://dx.doi.org/10.1097/MAO.0b013e31817dad57
[16] Kazikdas KC, Onal K, Boyraz I, Karabulut E. Palisade cartilage tympanoplasty for management of subtotal perforations: a comparison with the temporalis fascia technique. Eur Arch Otorhinolaryngol 2007; 264(9): 985-9. http://dx.doi.org/10.1007/s00405-007-0291-3
[17] Yu L, Han C, Yu H, Yu D. Auricular cartilage palisade technique for repairing tympanic membrane perforation. Zhoughau Er Bi Yan Hou Ke Za Zhi 2001; 36: 166-8.
[18] Iacovou E, Vlastarakos PV, Papacharalampous G, Kyrodimos E, Nikolopoulos TP. Is cartilage better than temporalis muscle fascia in type I tympanoplasty? Implications for current surgical practice. Eur Arch Otorhinolaryngol 2013;
[Epub ahead of print]. http://dx.doi.org/10.1007/s00405-012-2329-4

Downloads

Published

2013-02-02

Issue

Section

Articles