Double-Layered (Cartilage Island + Extra Perichondrium) Graft for Type 1 Tympanoplasty

2020 ◽  
Vol 163 (4) ◽  
pp. 806-813
Author(s):  
Onur Ismi ◽  
Kemal Gorur ◽  
Harun Gur ◽  
Cengiz Ozcan ◽  
Yusuf Vayisoglu
Keyword(s):  
Risk Index ◽  
Retrospective Chart Review ◽  
Layered Composite ◽  
Success Rates ◽  
Mild Disease ◽  
Type 1 Tympanoplasty ◽  
Tertiary Center ◽  
Risk Patients ◽  
Graft Success

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). However, there was no noticeable difference in C-ABG values within the patients with successful grafting ( P = .217). Only graft success status had a significant effect on C-ABG values when the multivariate linear regression was performed. ( P = .016). Higher MERI scores and presence of myringosclerosis were related to the unsuccessful grafting ( P < .01). Conclusion DLG tympanoplasty is encouraged, especially for patients with higher MERI scores, to increase the graft success rates. Better hearing outcomes of DLG tympanoplasty were related to the higher graft success status of this technique; DLG had no additional hearing effect for patients with successful grafting. Higher MERI scores and presence of myringosclerosis were related to graft failure.

scholarly journals Is Allergic Rhinitis a Factor That Affects Success of Tympanoplasty?

2016 ◽  
Vol 59 (1) ◽  
pp. 10-13
Author(s):  
Elif Ersoy Callioglu ◽  
A. Sami Bercin ◽  
Hayati Kale ◽  
Togay Muderris ◽  
Sule Demirci ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Success Rate ◽  
Middle Ear ◽  
Success Rates ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
Patient Groups ◽  
The Difference ◽  
Graft Success

Objective: The aim of the present study was to investigate the effect of allergic rhinitis on the success of the operation in chronic otitis surgery by using score for allergic rhinitis (SFAR). Materials and Methods: In the present study; 121 patients, who underwent type 1 tympanoplasty were examined retrospectively. SFAR of all patients were recorded. The graft success rates of 26 patients with allergic rhinitis (AR) and 95 patients with no allergic rhinitis group (NAR) were compared. Results: While the graft success rate in NAR group was 89.5%, this rate was 80.8% in the AR group. However, the difference between groups was not statistically significant (p = 0.311). Conclusion: These findings suggest that allergic rhinitis decreases the graft success rate of the pathologies occurring in eustachian tube, middle ear and mastoid although statistically significant difference wasn’t found. Prospective studies with larger patient groups are required in order to evaluate this pathology.

scholarly journals Boomerang-Shaped vs. Shield-Shaped Chondroperichondrial Cartilage Grafts for Type 1 Tympanoplasty in Children: A Study of 121 Patients

2017 ◽  
Vol 96 (10-11) ◽  
pp. 419-432 ◽  
Author(s):  
Can Özbay ◽  
Fatih Kemal Soy ◽  
Erkan Kulduk ◽  
Riza Dundar ◽  
Ahmet Yükkaldiran ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Graft Material ◽  
Success Rates ◽  
Cartilage Grafts ◽  
Type 1 Tympanoplasty ◽  
Grafting Technique ◽  
Study Population ◽  
Graft Success ◽  
The Impact

Many techniques and graft materials have been used for the reconstruction of the tympanic membrane. We conducted a retrospective study to compare anatomic and functional outcomes of type 1 tympanoplasty that we performed with boomerang-shaped chondroperichondrial cartilage grafts (BSGs) and shield-shaped chondroperichondrial cartilage grafts (SSGs) in pediatric patients. Our study population was made up 121 patients—61 boys and 60 girls, aged 7 to 16 years (mean: 12.4)—who had undergone a type 1 tympanoplasty. Patients were divided into two groups according to the grafting technique used; there were 59 patients in the BSG group and 62 patients in the SSG group. Ear examinations were performed at postoperative months 3, 6, 12, and 24, and pure-tone average (PTA) for air-conduction threshold values and air-bone gaps (ABGs) were evaluated at 0.5, 1.0, 2.0, and 4.0 kHz at the same visits. We also investigated the impact of the graft material on functional graft success and intergroup differences (if any) in surgical success. Mean postoperative follow-up periods were 30.5 and 30.2 months in the BSG and SSG groups, respectively. We found that the success rates for tympanic membrane reconstruction were not significantly different in the two groups (91.5 and 88.7%). Postoperatively, the mean PTA and ABG values in both groups at 3, 6, 12, and 24 months were significantly lower than the preoperative values (p < 0.05). There were no significant differences in mean PTA values between the two groups at 3, 6, 12, and 24 months. However, the extent of the decrease in PTA values in the BSG group at 3 months was significantly greater than that of the SSG group (p < 0.05). There were no significant differences in mean ABG values between the two groups at 3, 6, and 12 months, but at 24 months, the value was significantly higher in the BSG group (p < 0.05). Finally, the extent of the decrease in ABG in the BSG group at both 3 and 6 months was significantly greater than that of the SSG group (p < 0.05). We conclude that the BSG procedure is a reliable and safe method of performing pediatric tympanoplasty.

scholarly journals Outcome of Type 1 tympanoplasty: An experience at Biratnagar eye hospital in Eastern Nepal

2015 ◽  
Vol 7 (2) ◽  
pp. 55-60 ◽  
Author(s):  
Sanjeev Kumar Thakur ◽  
Sanjay Kumar Singh ◽  
Anwar Afaque ◽  
Nisha Ghimire
Keyword(s):  
Medical Sciences ◽  
Hearing Improvement ◽  
Hearing Outcome ◽  
Type 1 Tympanoplasty ◽  
Younger Age ◽  
History Of ◽  
The Mean ◽  
The Difference ◽  
Graft Success

Background: The history of tympanoplasty is well over a century. Type 1 tympanoplasty is an established procedure worldwide with a variation in the outcome.Aims and Objectives: To analyze the outcome of Type 1 tympanoplasty surgeries in terms of graft success and hearing improvement done at the Ear Department of Biratnagar eye hospital in eastern Nepal and discuss the various factors that might have influenced it.Materials and Methods: Retrospective analysis of records of the cases that underwent Type 1 tympanoplasty from August 2013 to January 2015 was done. The factors analysed were age, gender, the side of the affected ear and the perforation size. Appropriate Statistical test was applied and the results were discussed.Results: A total of 151 cases of type 1 Tympanoplasty were analysed were females had higher frequency than males, with higher incidence at younger age. The mean age of successful cases was 28.53. Females had a better success rate in terms of graft success compared to males. Moderate size perforations had the best outcome of graft success and least were of small size perforations. Of all cases analyzed, hearing improvement was observed in maximum cases.Conclusion: There was no significant influence of age or gender on the hearing outcome. The difference of hearing improvement according to size of perforation was also not significant.Asian Journal of Medical Sciences Vol.7(2) 2015 55-60

scholarly journals Comparison of the anatomical and functional success of fascia and perichondrium grafts in transcanal endoscopic type 1 tympanoplasty

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Kadir Özdamar ◽  
Alper Sen
Keyword(s):  
Retention Rates ◽  
Success Rates ◽  
Temporal Muscle ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
The Status ◽  
Group A ◽  
Group B ◽  
Age Range

Abstract Background There are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties. Objectives To compare the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy. Methods We enrolled a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with MERI scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation. The patients were assigned to two groups according to the type of the graft used. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane. Results There were no statistically significant differences in the distribution of the age, gender, localization, MERI scores, the duration of the operation, and the size of the perforation (all p values> 0.05). The pre-operative air-bone gap values of Group A and B did not show a statistically significant difference (p = 0.073). The postoperative improvement in the air-bone gap value did not demonstrate a significant difference between Group A and B (p = 0.202). The graft retention rates were 94.9 and 97.2% in Group A and in Group B respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.743). Conclusion Perichondrium and fascia were suitable for use in endoscopic tympanoplasties.

scholarly journals Outcome of ear surgeries in dry and wet ear

2017 ◽  
Vol 3 (3) ◽  
pp. 562 ◽  
Author(s):  
Shreyash C. S. ◽  
Rajneesh . ◽  
Rahul S.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Success Rates ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Time Of Surgery ◽  
Type 1 Tympanoplasty ◽  
Cortical Mastoidectomy

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) can present with dry and wet ear (discharging ear). It’s an accepted fact that an actively draining central perforation is not a contraindication for ear surgery. The discharging ear presents the otologists with the dilemma of operating on it or not, this is due to widespread belief that the success rate while doing ear surgeries on wet ears is decidedly inferior. Hence the present dissertation is intended to find the outcome of ear surgeries in dry and wet ear.</p><p class="abstract"><strong>Methods:</strong> The present study comprises of 60 patients who have undergone type 1 tympanoplasty with cortical mastoidectomy, at Fr Muller’s Medical College, Mangalore. These patients were divided into two groups- Wet and Dry, based on the presence or absence of ear discharge at the time of surgery respectively. Inclusion Criteria: Patients of age group 16-60 years and both sexes, with mucosal type of chronic otitis media who underwent type 1 tympanoplasty with cortical mastoidectomy. Exclusion criteria: Patients with squamosal type of chronic otitis media or with ossicular chain erosion. A comparative analysis was done on the hearing improvement and incidence of the graft uptake postoperatively between the two groups.</p><p class="abstract"><strong>Results:</strong> In dry group, complete graft uptake was seen in 90% cases, whereas in wet group, a graft uptake rate of 86.7% was achieved. The graft take up rate is better in high x socio-economic status. Higher take up rates were seen in small and medium perforation compared to subtotal perforations. Hearing improvement, assessed by mean gain of PTA at the end of 6th month postoperatively, was achieved in 86% cases in Wet group and 90% cases in Dry group. There was an average hearing improvement of 13.08 db in speech frequencies in 88.3% cases. The difference between the two groups was statistically insignificant.</p><p><strong>Conclusions:</strong> In our study, we found no statistically significant differences between the success rates of Wet and Dry group, either in terms of graft uptake or the hearing improvement. Thus, from our study, we conclude that the presence of ear discharge at the time of surgery does not affect the success rate of type 1 tympanoplasty. </p>

scholarly journals Comparison of Endoscopic Tympanoplasty with Microscopic Tympanoplasty

2020 ◽  
Vol 24 (4) ◽  
pp. 400-405
Author(s):  
Nausheen Qureshi ◽  
Muhammad Musharaf Baig ◽  
Misbah Parvez ◽  
Sundas Masood ◽  
Memoona Afzal
Keyword(s):  
Postoperative Pain ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Bone Conduction ◽  
Type 1 Tympanoplasty ◽  
Graft Success ◽  
Microscopic Tympanoplasty ◽  
Endoscopic Tympanoplasty ◽  
Endoscopic Group

Background: Minimally invasive surgery has recently been developed along with endoscopic techniques. Endoscopic Ear Surgery is becoming popular with its anatomic and physiologic concepts. Tympanoplasty is one of the commonest operations performed for the middle ear. While using the endoscope we can place the graft accurately while avoiding unnecessary post or endaural incision and soft tissue dissections which are mandatory during tympanoplasty using a microscope.  Our study was aimed to compare the outcomes of endoscopic and microscopic tympanoplasty in terms of graft uptake, hearing outcome and postoperative pain. Methods:  This is a retrospective comparative study of 63 patients who underwent type 1 tympanoplasty at Holy Family Hospital ENT Department from March 2017 to March 2020. The subjects were classified into 2 groups; Endoscopic tympanoplasty (ET, n=30),  Microscopic Tympanoplasty (MT, n=33). Type 1 Tympanoplasty, was the procedure done on patients of both the groups. Demographic data, perforation size of the tympanic membrane at preoperative state, pure tone audiometric results preoperatively and 3 months postoperatively, operation time, sequential postoperative pain scale (NRS-11), and graft success rate were evaluated.  Results : The perforation size of the tympanic membrane in the Endoscopic group and the microscopic group was nearly the same (p=.877). Pre and post-operative air-bone gaps including air and bone conduction thresholds were not significantly different between the two groups. The graft success rate in the endoscopic and Microscopic group was 93.3% and 63.3% respectively; the values were significantly different(p=0.0046). Immediate and 6 hours postoperative pain was similar in both the groups, however pain on ist postoperative day was significantly lower in the endoscopic group. Conclusion: We can do minimal invasive tympanoplasty with the help of endoscopes with better graft success rate, less preoperative time, and less postoperative pain.

scholarly journals Evaluation of Prognostic Factors and Middle Ear Risk Index in Type 1 Tympanoplasty

2021 ◽  
Vol 83 (1) ◽  
pp. 1569-1574
Author(s):  
Mohamed Modather Abd ElNaem ◽  
Ahmed Aboulwafa Abdul Jaleel ◽  
Asmaa Nabil Mohamed
Keyword(s):  
Prognostic Factors ◽  
Middle Ear ◽  
Risk Index ◽  
Type 1 Tympanoplasty

1548: Racial Disparities in Kidney-Transplant Graft Outcomes, with a Proposal to Improve Graft Success Rates

2005 ◽  
Vol 173 (4S) ◽  
pp. 419-419
Author(s):  
Constance Marks ◽  
Carlumandarlo E.B. Zaramo ◽  
Joan M. Alster ◽  
Charles Modlin
Keyword(s):  
Racial Disparities ◽  
Kidney Transplant ◽  
Success Rates ◽  
Graft Success

scholarly journals 84. T2Candida Panel Use Evaluation: a Quality Improvement Project

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S59-S59
Author(s):  
Erika Reategui Schwarz ◽  
Meenakshi Rana ◽  
Rachel Chasan ◽  
Melissa R Gitman
Keyword(s):  
Invasive Candidiasis ◽  
Retrospective Chart Review ◽  
Blood Cultures ◽  
Negative Group ◽  
Improvement Project ◽  
Positive Group ◽  
Negative Results ◽  
Risk Patients ◽  
Life Threatening ◽  
Antifungal Use

Abstract Background Invasive candidiasis is a life-threatening infection with 40% mortality despite antifungal therapy[1] A retrospective chart review of results from our T2Candida Panels from March 2019 to March 2020 was conducted. We compared demographics, co-morbidities, days of antifungal use, length of stay (LOS) and mortality in patients with positive and negative assays. Results 271 assays were performed, 27 were positive and were compared to 81 negatives. Baseline demographics and co-morbidities were similar in both groups. All patients tested had &gt;1 risk factor for candidemia. 78% were positive for C. albicans/C. tropicalis and 11% positive for C. glabrata/C. krusei and C. parapsilosis respectively. Blood cultures were positive in 8 individuals, of which 5 had a positive assay; among the other 3, one grew C. auris. All species in the T2Candida matched the blood cultures when available. β-D-glucan was positive in 82% of patients with positive T2 results vs 46% in the T2 negative group (p = 0.016). Antifungal administration within the time of assay collection was 54% in the negative group vs 74% in the positive group (p = 0.030). Mean duration of antifungal use were significantly lower in the negative group than the positive group (5.98 vs 17.55 days, p = 0.04). Demographics and Comorbidities Outcomes Cultures Conclusion T2Candida was an effective diagnostic and antimicrobial stewardship tool, leading to testing in high risk patients and reducing unnecessary antifungal use. Additional education is required for improved ordering of concurrent blood cultures. Negative results should be interpreted with caution in suspected invasive candidiasis with consideration for species not included in the panel. Disclosures All Authors: No reported disclosures

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