Type 1 Revision Tympanoplasty Using Tragal Cartilage in a Tertiary Care Centre: A Prospective Observational Study

Overview

Journal Indian J Otolaryngol Head Neck Surg

Publisher Springer

Date 2022 Aug 29

PMID 36032918

Authors

Kartik Irappa Patil

Ramabhadraiah Anil Kumar

Hosaagrahara Subbegowda Satish

Affiliations

Soon will be listed here.

Abstract

To evaluate graft success rate and hearing outcome in type 1 revision tympanoplasty using tragal cartilage graft. It is a prospective observational study conducted at Department of ENT, Bangalore Medical College and Research Institute from July 2017 to June 2019. Forty four patients between the age group 18-60 years undergoing type 1 revision tympanoplasty, with conductive hearing loss were enrolled.There were 27 males and 17 female patients in the study group. Cartilage tympanoplasty was done using thin tragal cartilage graft . Postoperative hearing gain and graft uptake was assessed at third month. Graft uptake and hearing improvement was assessed 3 months postoperatively in 44 patients. Forty patients had graft uptake (90.90%). The postoperative hearing gain was 7.12 ± 2.99 dB ( = 0.001) which was statistically significant. Tragal cartilage is a good option as graft material in revision cases in terms of ease of graft placement, better graft uptake and audiological outcome with no complications like lateralization of graft, medialization of graft, epithelial pearl formation and anterior blunting.

References

Sheehy J, Anderson R . Myringoplasty. A review of 472 cases. Ann Otol Rhinol Laryngol. 1980; 89(4 Pt 1):331-4. DOI: 10.1177/000348948008900407. View

Angeli S, Kulak J, Guzman J . Lateral tympanoplasty for total or near-total perforation: prognostic factors. Laryngoscope. 2006; 116(9):1594-9. DOI: 10.1097/01.mlg.0000232495.77308.46. View

Dornhoffer J . Cartilage tympanoplasty. Otolaryngol Clin North Am. 2006; 39(6):1161-76. DOI: 10.1016/j.otc.2006.08.006. View

Altuna X, Navarro J, Algaba J . Island cartilage tympanoplasty in revision cases: anatomic and functional results. Eur Arch Otorhinolaryngol. 2011; 269(10):2169-72. DOI: 10.1007/s00405-011-1875-5. View

Webb B, Chang C . Efficacy of tympanoplasty without mastoidectomy for chronic suppurative otitis media. Arch Otolaryngol Head Neck Surg. 2008; 134(11):1155-8. DOI: 10.1001/archotol.134.11.1155. View

Dornhoffer J . Cartilage tympanoplasty: indications, techniques, and outcomes in a 1,000-patient series. Laryngoscope. 2003; 113(11):1844-56. DOI: 10.1097/00005537-200311000-00002. View

Kaylie D, Gardner E, Jackson C . Revision chronic ear surgery. Otolaryngol Head Neck Surg. 2006; 134(3):443-50. DOI: 10.1016/j.otohns.2005.10.044. View

Milewski C . Composite graft tympanoplasty in the treatment of ears with advanced middle ear pathology. Laryngoscope. 1993; 103(12):1352-6. DOI: 10.1288/00005537-199312000-00006. View

Veldman J, Braunius W . Revision surgery for chronic otitis media: a learning experience. Report on 389 cases with a long-term follow-up. Ann Otol Rhinol Laryngol. 1998; 107(6):486-91. DOI: 10.1177/000348949810700606. View

10.

Tos M . Cartilage tympanoplasty methods: proposal of a classification. Otolaryngol Head Neck Surg. 2008; 139(6):747-58. DOI: 10.1016/j.otohns.2008.09.021. View

11.

Duckert L, Muller J, Makielski K, Helms J . Composite autograft "shield" reconstruction of remnant tympanic membranes. Am J Otol. 1995; 16(1):21-6. View

12.

Djalilian H . Revision tympanoplasty using scar tissue graft. Otol Neurotol. 2006; 27(2):131-5. DOI: 10.1097/01.mao.0000190462.50755.f2. View

13.

Ruhl C, Pensak M . Role of aerating mastoidectomy in noncholesteatomatous chronic otitis media. Laryngoscope. 1999; 109(12):1924-7. DOI: 10.1097/00005537-199912000-00005. View

14.

Page C, Charlet L, Strunski V . Cartilage tympanoplasty: postoperative functional results. Eur Arch Otorhinolaryngol. 2008; 265(10):1195-8. DOI: 10.1007/s00405-008-0619-7. View

15.

Kazikdas K, 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. DOI: 10.1007/s00405-007-0291-3. View

16.

Gun T, Boztepe O, Atan D, Ikinciogullari A, Dere H . A Comparison of Cartilage Palisades and Temporal Fascia in Type 1 Tympanoplasty for Bilateral Tympanic Membrane Perforations in Children. J Int Adv Otol. 2016; 13(1):36-39. DOI: 10.5152/iao.2016.1855. View

17.

Sismanis A, Dodson K, Kyrodimos E . Cartilage "shield" grafts in revision tympanoplasty. Otol Neurotol. 2008; 29(3):330-3. DOI: 10.1097/mao.0b013e318161aae1. View

18.

Moore G . Candidate's thesis: Revision tympanoplasty utilizing fossa triangularis cartilage. Laryngoscope. 2002; 112(9):1543-54. DOI: 10.1097/00005537-200209000-00003. View

19.

Kartush J, Michaelides E, Becvarovski Z, LaRouere M . Over-under tympanoplasty. Laryngoscope. 2002; 112(5):802-7. DOI: 10.1097/00005537-200205000-00007. View

20.

Chang C, Gray L . Pressed scar tissue for tympanic membrane grafting in revision tympanoplasty. Otolaryngol Head Neck Surg. 2005; 132(1):30-6. DOI: 10.1016/j.otohns.2004.09.086. View