The audiological and take results of perichondrium attached cartilage island graft in tympanoplasty: PACIT (original) (raw)
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Hearing results after primary cartilage tympanoplasty with island technique
Otolaryngology - Head and Neck Surgery, 2005
OBJECTIVE: Because of its rigid quality, cartilage is the grafting material of choice in advanced pathologies, such as adhesive processes or recurrent perforations. However, the use of such a rigid material in tympanic membrane reconstruction causes controversies as to the audiologic aspect. The purpose of this study was to assess overall and frequencyspecific hearing results after primary cartilage tympanoplasty with island technique in comparison to the hearing results after primary tympanoplasty with temporalis muscle fascia.
Middle Black Sea Journal of Health Science, 2020
Objective: Chronic otitis media (COM) treatment aims to obtain a dry middle ear mucosa as much as possible with medical treatment and to closure the perforation in the tympanic membrane with the help of various graft materials after the eradication of the disease. In the presence of perforation, the surface area of the tympanic membrane is decreases, which causes a decrease in the sound pressure in the middle ear and adversely affect hearing. At present, there is no globally accepted standardization of factors affecting anatomical success of the graft and hearing outcomes. In this study, the effect of perforation size and site in the tympanic membrane on anatomic success and hearing was investigated in cases where autogenic composite tragal cartilage graft material was used. Methods: The patients were classified in groups with respect to the perforation site (central or marginal) and size (large if the perforation comprised more than 50% of the membrane area, and small if it comprised less) in the tympanic membrane. Anatomical success and preoperative-postoperative mean air bone gap pure tone average (ABG PTA) values of the graft were separately calculated for each group, and the ratios were compared. Results: In 69 patients who underwent Type 1 tympanoplasty with mastoidectomy, 48 tympanic membrane perforations were central, 21 were marginal, 46 were small, and 23 were large. Graft anatomic success rates were 91.7% in the central group, 66.7% in the marginal group, 89.1% in the small group, and 73.9% in the large group. The anatomical success of the central group was found to be significantly higher than that of the marginal group. No difference was found between the small and large groups. When the effect on hearing was calculated, the postoperative hearing levels were significantly better in the central group. Conclusion: Perforation size had no effect on the anatomical success and hearing level of the graft, while the perforation site affected both the anatomical success of the graft and the hearing level.
European Archives of Oto-Rhino-Laryngology, 2019
Objectives To evaluate and compare functional outcomes of tympanoplasty procedures with temporalis fascia and four different types of cartilage grafts in chronic otitis media (COM) cases with normal preoperative hearing levels. Methods Records of patients who underwent type 1 tympanoplasty for non-complicated COM in a tertiary medical center between January 2010 and January 2017 were reviewed. Patients with central or marginal and dry perforations of the tympanic membrane, normal middle ear mucosa, intact ossicular chain and patients with a preoperative pure tone average (PTA) level of 25 dB or less and a word recognition score (WRS) of 88% or greater were included in the study. Graft success rates, preoperative and postoperative functional outcomes, and anatomical results were analyzed. Results One hundred and forty-four patients who met the inclusion criteria were evaluated in the study. PTA and Air-bone gap (ABG) levels decreased significantly both in TF and CG groups after the surgery (p = 0.001). Similarly, WRS scores increased significantly in both groups (p = 0.001). There was not a significant difference in terms of PTA increase, WRS increase, and ABG closure levels between cartilage and TF groups. Increase in PTA, closure in ABG, and increase in WRS levels were compared among TF, WsCCG, MCG, PCG, and CPIG groups. The increase in PTA levels was also found to be significantly superior in the TF group (p = 0,023). However, the multivariate analysis showed no significant difference for increase in WRS, closure in ABG and increase in PTA levels according to graft type (p = 0.285; p = 0.461; p = 0.106, respectively) and gender (p = 0.487; p = 0.811; p = 0.756, respectively). Conclusion In COM cases with normal preoperative hearing, both TF and cartilage lead to superb functional and anatomical outcomes. There was not a significant difference in terms of PTA increase, WRS increase and ABG closure levels between cartilage and TF groups. The graft success rate of cartilage was found to be superior to TF, but there was not a statistically significant difference. Different types of cartilage grafts can be used in cases with normal preoperative hearing without the concern of hearing impairment.
Cartilage graft in type I tympanoplasty: audiological and otological outcome
European Archives of Oto-rhino-laryngology, 2008
The aim of this study is to evaluate anatomical and audiological results of cartilage tympanoplasty compared to fascia tympanoplasty in the reconstruction of tympanic membrane perforations. We carry a retrospective study about 380 patients operated in our department between 1998 and 2005. Patients were classified into two groups: 90 (23.6%) undergo cartilage tympanoplasty and 290 (76.4%) fascia tympanoplasty. In each group, we calculated the average of pre and postoperative air bone gap (ABG) and the average air conduction gain (ACG) at 250–4,000 Hz. The surgical technique is explained in detail. We detail and analyze the audiological and anatomical results in each group. Successful closure of the tympanic membrane perforation was achieved in 97% of the cartilage group as compared to 94% of the fascia group. The average ACG was 21 ± 11 dB in cartilage group and 20 ± 22 dB in fascia group. With an average follow-up of 2 years, residual perforation was observed in 2.2% in cartilage group. Reperforation of fascia graft and retraction were noted in 2.1 and 1%, respectively. The authors show the great reliability of cartilage tympanoplasty to close tympanic membrane perforations. We recommend using cartilage as a first choice, especially in stable or evolutive chronic otitis media, and in recurrent perforation of the tympanic membrane.
Double-Layered (Cartilage Island + Extra Perichondrium) Graft for Type 1 Tympanoplasty
Otolaryngology–Head and Neck Surgery, 2020
Objective To compare the graft success rates and hearing results of single-layered (composite island) grafting (SLG) vs double-layered (composite plus second layer of perichondrium) grafting (DLG) for over-under type 1 tympanoplasty techniques. Study Design Retrospective chart review. Settings Tertiary center otorhinolaryngology clinic. Subjects and Methods Medical charts of the patients who underwent type 1 tympanoplasty via the microscopic technique by a single surgeon between 2015 and 2019 were analyzed. Results A total of 48 patients were included. The DLG (n = 26) group had higher graft take rates as compared to the SLG group (n = 22) for all patients ( P = .038) and for moderate- to high-risk patients according to Middle Ear Risk Index (MERI) scores ( P = .029) but not for patients with mild disease ( P = .429) or myringosclerotic patients ( P = .242). The DLG group exhibited higher air-bone gap closure (C-ABG) values as compared to the SLG group for all patients ( P = .018). ...
Transcanal Tympanoplasty with Cartilage-Perichondrium Composite Graft
Journal of Academic Research in Medicine, 2015
Objective: The aim of this study was to evaluate the results of transcanal tympanoplasty surgery performed using a cartilage-perichondrium composite graft. Methods: Forty patients were included in this study. Their tympanic membrane (TM) perforations were limited to one quadrant, and there was a longterm hearing loss. All patients who had undergone surgery had a dry ear for at least 6 months. All patients had undergone transcanal tympanoplasty surgery with the cartilage-perichondrium composite graft, and the success of the surgery was evaluated by physical examination and audiological evaluation after 6 months of surgery. Results: After the surgery, 35 (87.5%) patients had an intact tympanic membrane. There was a statistically significant decrease in the air-bone gap of patients' hearing levels (mean preoperative hearing level, 21.29 dB; mean postoperative hearing level, 13.23 dB; p<0.01). Conclusion: Cartilage-perichondrium composite graft usage with transcanal tympanoplasty surgery takes shorter time than other methods. The procedure shows less morbidity because of no disruption of the normal anatomy, absence of a big and visible incision, and no elevation of the tympanometal flap. Also, the mean hospitalization time is lesser; we had similar success with the standard tympanoplasty procedures.
The Egyptian Journal of Otolaryngology, 2021
Various grafting materials and different techniques have been used for myringoplasty. The aim of the study was to compare the result of tympanoplasty in patients with safe-type chronic suppurative otitis media using periosteum versus tragal cartilage with perichondrium grafts through pre- and postoperative clinical and audiological evaluation. There was statistically significant difference for mean air-bone gap for group A (23.4 dB ± 0.03 SD) when compared to group B (19.4 dB ± 4.2 SD) with P value 0.103. Also, there was statistically significant difference in the hearing gain in group A after 6 months (25.53 dB ± 6.26 SD) when compared to group B (19.63 dB ± 9.76 SD) and the P value was 0.003. Graft taken was superior in the periosteal group (95%), compared to the cartilage grafts (90%). Tympanoplasty with periosteal graft showed better hearing results and high rates of graft taken than tragal cartilage grafts.
Role of cartilage graft in type 1 tympanoplasty: audiological and otologic outcomes
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: Temporalis fascia is the most commonly used graft material for the tympanic membrane perforations. Due to high failure rate of temporalis fascia in adhesive otitis media, large perforations and advanced middle ear pathology alternate graft materials which are more rigid and resistant to infection are being used. Cartilage graft has shown to be a promising graft material in such cases. The purpose of this study was to evaluate the functional and anatomic results with cartilage graft in type 1 tympanoplasty.Methods: The present prospective study was conducted among 40 patients of chronic otitis media between 11-60 years of age requiring tympanoplasty in department of ear, nose and throat (ENT) in Government Medical College and Rajindra Hospital, Patiala. Results: The overall success rate of type 1 cartilage tympanoplasty was 85% in terms of perforation closure and post operative pure tone audiometry (PTA) at 6 weeks was 37.24 and at 12 weeks PTA was 34.27 The p value was ...
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2016
Background: The objective of the study was to evaluate the anatomical and audiological outcomes of cartilage-perichondrium composite graft tympanoplasty by underlay technique in revision tympanoplasties. Methods: A series of 55 patients who underwent revision tympanoplasty with cartilage-perichondrium composite Island graft, at the department of Otorhinolaryngology, Harsh ENT Hospital, Ghaziabad. Tympanoplasty with cartilage-perichondrium composite island graft was done using underlay technique after slicing the cartilage with help of slicer. Ossiculoplasty was performed as and when needed. Results: Graft uptake rate was found to be 96.36% (53 of the 55 cases) in our study without any serious complications. Audiological outcomes with closure of 94.55% air bone gap within 0 to 30 dB was achieved (p <0.05). Conclusions: Nearly 97% success rate can be achieved with cartilage-perichondrium composite graft tympanoplasty for Revision tympanoplasty.
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2021
Background: The main objective of the study was to assess the anatomical and functional results of cartilage tympanoplasty using full thickness cartilage graft (with or without perichondrium) reinforced with fascia in high risk situations.Methods: This prospective non-controlled, non-randomized study included 124 cases of chronic otitis media who underwent cartilage (reinforcement) tympanoplasty (underlay) and ossicular reconstruction with or without mastoidectomy in following seven groups: revision cases, atelectatic cases, subtotal perforation (dry), larger anterior perforations (dry), tympanosclerosis, cholesteatomatous ear, and wet (discharging) ears . Graft success was accepted labelled as an intact graft at the end of six month postoperatively. At the same time, hearing results were also assessed by comparing pre- and post-operative pure tone average air-bone gap (PTA-ABG) of each group using Student “t” test and p<0.05 was considered statistically significant for the he...