Technique of Extending Cartilage Perichondrium Composite Graft into the External Auditory Canal in Type 1 Tympanoplasty and Evaluation of Graft Success.

Indian J Otolaryngol Head Neck Surg

Department of Ear Nose and Throat Diseases, Bandırma Onyedi Eylül University Faculty of Medicine Yeni Mahalle, Şehit Astsubay, Mustafa Soner Varlık Street Number:75, Bandırma/Balıkesir, 10200 Turkey.

Published: December 2024

AI Article Synopsis

  • Cartilage perichondrium composite grafts (CPCG) were utilized in tympanoplasty to address issues such as reperforations, with a goal to improve graft techniques and evaluate their success.
  • The study involved 54 ear operations on 48 patients, revealing significant improvements in audiological measurements following the procedure, with a graft success rate of 94.4%.
  • Modifications to the grafts aimed to reduce the chance of reperforation and improve auditory outcomes, indicating that CPCG is effective even for high-risk ear perforations.

Article Abstract

Unlabelled: Cartilage perichondrium composite grafts (CPCG) have been used in tympanoplasty for many years. Reperforations can be seen because of various problems. The aim of our study is to describe a graft technique to minimise the complications and to evaluate the success of the graft. The ears which underwent type 1 tympanoplasty using CPCG were included in the study. Over-underlay graft technique was used in all operations. They were performed by microscopic transcanal approach and by the same surgeon. Fifty-four ear operations of 48 patients were included in the study. While the preoperative average pure tone- average (PTA) of the ears was 45 (21-75) dB, the postoperative average PTA was 28 (11-58) dB. While the preoperative air bone gap (ABG) of the ears was 23.3 (10-43.3) dB, the postoperative ABG was 11.6 (0-28.3) dB. A significant improvement was achieved in both ABG and PTA values after the operation ( < 0.001). The graft success rate was 94.4%. The cartilage graft modifications such as block cartilage, palisade, cartilage island and butterfly have been applied successfully. We aimed to reduce the risk of reperforation, maximise audiological gain and facilitate the follow-up of postoperative middle ear pathologies by thinning the cartilage island and extending the perichondrium to the external auditory canal in the modification of CPCG. The graft success rate and the audiological success rate are high enough to be compared with the literature. The described CPCG can be used safely in all types of perforations, especially in high-risk perforations.

Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04965-5.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569364PMC
http://dx.doi.org/10.1007/s12070-024-04965-5DOI Listing

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