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Πέμπτη 8 Απριλίου 2021

Endaural Over-Underlay Cartilage Tympanoplasty for Repair of Dry Subtotal Perforations

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Ann Otol Rhinol Laryngol. 2021 Apr 7:34894211007218. doi: 10.1177/00034894211007218. Online ahead of print.

ABSTRACT

OBJECTIVES: We explored the auditory and anatomical success of grafting when the cartilage perichondrium (CP) was prepared using two different methods.

METHODS: Patients with subtotal or total perforation underwent tympanoplasty with a CP graft. A V-shaped groove for the handle of the malleus was prepared for CP grafts in patients in group 1. Pati ents in group 2 did not have a groove on the graft. The anatomical success of the graft was evaluated as success, partial success, or failure. Results of auditory evaluations were compared between the two groups.

RESULTS: A total of 195 patients were included in the study. The total CP graft integration rate was 96% for both groups. Significant changes were detected in all hearing criteria evaluated 12 months after surgery compared to the preoperative period (P < .05). There were no significant differences between the groups in terms of the relationship between graft technique and postoperative hearing results. However, rates of partial success were significantly higher for group 1 than group 2 (P = .033).

CONCLUSION: Cartilage slice support offers an extremely reliable method for reconstruction of tympanic membrane in cases of high-risk perforation. Partial failures are rare, but when they occur, they most often involved anterior graft medialization. Wh en a piece of cartilage is removed at the malleus interface there may be a higher rate of partial failure.

PMID:33825491 | DOI:10.1177/00034894211007218

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