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The aim of the present study is to report our results with cartilage "shield" tympanoplasty (CST) for total tympanic membrane perforations. A retrospective chart review of patients undergoing CST was performed in tertiary referral centers. One hundred and seventy-seven patients who had undergone CST were identified. Patients' age ranged from 7 to 7...
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p class="abstract"> Background: Chronic otitis media (COM) is a common health problem in developing world and has a major impact on patient in the form of hearing loss. Temporalis fascia is commonest graft material used for tympanoplasty as it is readily available through same post aural incision. The study was conducted with an aim to find out the...
Objectives
To conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) that examined the efficacy of dry versus wet temporalis fascia graft among patients undergoing type-I tympanoplasty.
Methods
Web of Science, Scopus, PubMed, and CENTRAL databases were screened from inception until July 2022. The Cochrane risk of...
Objective and intervention
To compare the efficacy of the inlay, composite chondroperichondrial clip (triple-C) tympanoplasty with conventional underlay cartilage island tympanoplasty, and to evaluate its efficacy in treating large, marginal perforations.
Study design
The study involved 183 patients that were selected from a retrospective chart re...
Objectives
Tympanoplasty is a procedure used to eradicate disease in the middle ear and to reconstruct the hearing mechanism. Assessment of the success
rate and efficacy of the technique of composite chondroperichondrial clip tympanoplasty for repair of small and medium sized tympanic membrane
perforations and to assess this graft and audio logical...
Citations
... There are no conflicts of interest. [11] Cymba concha ...
... With regard to functional outcomes, our observation is in line with that of Iacovou et al., in which 117 patients with total TM perforation who had undergone cartilage "shield" tympanoplasty had a postoperative follow-up for 24 months. [16] The average pre-and postoperative PTA-ABG was 32.06 ± 11.21 db and 18.69 ± 10.53 db, respectively. The overall average ABG improvement was 13.37 ± 9.34 db. ...
Background: The prevalence of chronic otitis media in the Armed Forces is high. Moreover, management of high-risk perforation and atelectatic ear is an even greater challenge. It is necessary to assess the most viable management approach to achieve an optimal outcome. Aims and Objectives: We aimed to compare anatomical and audiological results in tympanoplasty for high-risk perforation and atelectasis using perichondrium-cartilage island (PCI) graft with temporalis fascia (TF) graft. Materials and Methods: A retrospective study was carried on 110 patients. Fifty-four patients and 56 patients underwent PCI graft and TF tympanoplasty, respectively. Postoperative graft integration rates and hearing outcomes were compared. Chi-square test was carried out to compare postoperative graft uptake. Postoperative audiological outcomes were compared using t-tests. Results: At 2-year follow-up, the graft take-up rate for PCI graft and TF graft was 96.29% and 82.14%, respectively (statistically significant). In the TF group, 17.86% had reperforation and recurrence of retraction pockets. In the PCI group, 3.71% had recurrent perforation. Furthermore, there was a statistically significant in the postoperative long-term improvement in pure-tone average air-bone gap in the cartilage island graft group (15.01 ± 3.53 db vs. 21.96 ± 4.09 db, P < 0.05). Conclusion: PCI graft achieves better morphological and audiological results in comparison to TF graft in high-risk perforation and atelectatic ears. It has a higher graft integration rate and better long-term audiological outcomes.
... In our study, on pre-operative hearing assessment 33% had hearing loss in the range of 31-40 dB. 49 % patients showed post-operative ABG in the range of 0-10 dB.In comparison to our study in a study conducted by Emilia et al.11 the average gain in ABG was about 15 dB for type I tympanoplasty with conchal cartilage.In a similar study conducted by Vadiya et al 60 cases (92.30%) had less than 20 dB ABG at 6 months postoperative.12 In a study conducted by Kyrodimos et al the pre and postoperative PTA-ABG was 52.2±17.7 dB and 35.4±17.9 ...
p class="abstract"> Background: Tympanoplasty is a surgical procedure performed to reconstruct hearing mechanism with or without reconstruction of tympanic membrane perforation. Cartilage shield tympanoplasty was first reported in literature by Duckert et al in 1995.The purpose of the present study was to prepare the cartilage shield graft and to evaluate its effect on the success rate of tympanoplasty.
Methods: In this study 70 patients who presented to ENT OPD of Aarupadai Veedu medical college, Puducherry, with chronic otitis media (COM) mucosal type, who were treated during the period between December 2016 to April 2018 were enrolled. Patients with COM mucosal type, with mild to moderate conductive hearing loss, dry or moist ear were included in the study. Detailed history was taken in the selected patients including a thorough otological examination and blood investigations required for surgery.
Results: In the present study male to female ratio was 1.6:1. 30% patients were in the age group between 20-24years. In our study 33% patients had pre-operative airbone gap in the range of 31-40 dB and post-operative improvement in airbone gap was in the range of 0-10 dB in 49% patients.
Conclusions: Conchal cartilage shield tympanoplasty is an effective technique in tympanic membrane reconstruction and shows no detrimental effect to the hearing outcome. Conchal cartilage is preferred graft as it can be harvested from same incision. The graft uptake rates are excellent with this technique.</p
... Cartilage shield technique of tympanoplasty (CST) has shown many promising results so far in various studies [1,2] and has added a dependable alternative to conventional use of only fascia to obtain indisputable success rates of tympanic membrane reconstruction. The current study aims at comparing graft uptake rates and hearing improvement in temporalis fascia (TF) tympanoplasty and modified CST in Indian patients at a tertiary care center in rural area by analysis of 142 surgeries and their follow-up findings from retrospective data. ...
The current study compares outcomes of modified cartilage shield tympanoplasty (CST) with temporalis fascia tympanoplasty in type I procedures in Indian patients. Graft uptake rates are better with the CST technique and hearing results are almost equivalent with both techniques except at 8000 Hz where improvement in hearing was found better with the use of temporalis fascia alone. The CST technique used in the study is unique.
... Zöllner and Wullstein, from Germany, first introduced tympanoplasty in early fifties. 1 The various graft materials used to repair tympanic mem brane are skin, temporalis fascia, fascia lata, perichon drium, cartilage, vein and dura mater. 2 The most commonly employed material till date is temporalis fascia with a successful closure rate of approximately 90% of primary tympanoplasty. 3 The use of cartilage in middle ear surgery dates back to 1959, when it was used in management of retraction pockets. ...
Objective
Cartilage shield tympanoplasty (CST) is an acknowledged procedure to repair total tympanic membrane perforations. The main objective of this study was to share our experience of CST, in form of its technique, graft uptake and hearing outcomes.
Study design
Retrospective chart review.
Setting
Tertiary care hospital, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Patients
A total of 69 cases of type 1 CST, from January 2013 to March 2014. We followed all patients for a minimum period of 6 months.
Intervention
Therapeutic.
Main outcome measures
Graft uptake rate, along with preand postoperative pure tone audiogram air bone gap (ABG) and postoperative complications, was evaluated. We compared ABG using Student's t-test.
Results
Graft uptake was seen in 68 cases (98.5%). The mean pre- and postoperative pure tone audiometry (PTA)-ABG was 37.58 ± 6.43 dB and 20.19 ± 8.14 dB, respectively. Hearing improvement was maximum at 2 kHz with mean postoperative value of 17.73 dB, and the least improvement was seen at 8 kHz with value of 30 dB in postoperative period.
Conclusion
The graft uptake rate was excellent, and hearing results were satisfactory. Cartilage shield tympanoplasty should be a recommended procedure for total perforation, subtotal perforation and revision cases. However, long-term results are still awaited.
How to cite this article
Patadia S, Keshri A, Shah S. Cartilage Shield Tympanoplasty: A Retrospective Chart Review of 69 Cases. Int J Otorhinolaryngol Clin 2015;7(3):105-108.
... Emilia et al., [6] used conchal cartilage and the average gain in ABG was about 15 dB for type I tympanoplasty and about 10 dB in type III tympanoplasty. Dornhoffer [7] and Neumann et al., [8] have described use of cartilage palisade technique and cartilage-perichondrium island technique with good results. ...
Aim: Use of cartilage for repair of tympanic membrane is recommended by many otologists. The current study aims at evaluating results of cartilage shield tympanoplasty in terms of graft take up and hearing outcomes. Material and Methods: In the current study, cartilage shield tympanoplasty(CST) is used in ears with high risk perforations of the tympanic membrane. A total of 40 ears were selected where type I CST was done in 30 ears and type III CST was done in 10 ears. Results: An average of 37.08 dB air bone gap(ABG) was present in pre operative time and an average of 19.15 dB of ABG was observed at 6 months after the surgery with hearing gain of 17.28 dB on average was observed. Graft take up rate of 97.5% was observed. The technique is modified to make it easier and to minimize chances of lateralization of graft. Conclusion: The hearing results of this technique are comparable to other methods of tympanic membrane repair.
Objective
Here, we aimed to compare the operation time, postoperative pain score, graft healing, graft success rate, cholesteatoma incidence, audiometric outcomes, and complications between endoscopic modified myringoplasty (EMM) and endoscopic typical myringoplasty (ETM).
Methods
Patients with unilateral chronic tympanic membrane (TM) perforations undergoing myringoplasty were prospectively randomized to undergo EMM (n = 44) or ETM (n = 45). The operation time, postoperative pain score, graft healing, graft success rate, cholesteatoma incidence, audiometric outcomes, and complications were compared between these groups.
Results
In total, 89 patients with unilateral chronic perforations were included (EMM group, 44; ETM group, 45). There were significant differences between the EMM and ETM groups in mean pain scores on the day after surgery (1.32 ± 0.56 vs. 2.58 ± 1.16, p < 0.001) and in the mean operation time (18.18 ± 2.43 vs. 51.53 ± 8.28 min, p < 0.001). There were no significant differences in graft success rates (93.18% vs. 88.89%, p = 0.735), pre- or postoperative air conduction pure-tone averages or air bone gaps (ABGs), or changes in ABGs between the groups. However, the difference in graft healing was significant at postoperative week 2 (33/44 vs. 24/45, p = 0.033) but was nonsignificant at postoperative week 4 and month 6. Computed tomography revealed the middle ear and mastoid to be well pneumatized at 12 months in all patients.
Conclusion
While 12-month graft and audiometric outcomes were comparable between EMM and ETM techniques, patients who underwent EMM had less postoperative pain, shorter operative times, faster healing, and a lower incidence of complications.
Level of Evidence
1 Laryngoscope, 2022
To compare short and long-term graft uptake and hearing outcome of type I cartilage tympanoplasty between small, medium and large perforations using reinforced sliced conchal cartilage. A retrospective study conducted in a tertiary center. Fifty patients who under went type I tympanoplasty were enrolled. Their mean age was 29.30 years and follow-up time was 6 and 18 months. The preoperative, postoperative short-term and long-term hearing and graft uptake results were analyzed. Graft uptake rate was 96% in short-term and 98% in long-term with one residual perforation in medium size, but 100% in small and large perforations (P < 0.01). Short and long-term ABG closure was identical in small and medium size perforation (P = 0.978) (P = 0.734), but, large perforation showed significant improvement in long-term (P = 0.012). Sliced conchal cartilage reinforced with temporalis fascia is a reliable technique for tympanoplasty. In long-term, large perforations have better graft uptake rate and continuous hearing improvement and ABG closure than small and medium perforations.
