The effect of perforation size and site on graft success and hearing in Type 1 Cartilage Tympanoplasty

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.

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

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i2.13357 ◽

2015 ◽

Vol 7 (2) ◽

pp. 55-60 ◽

Cited By ~ 1

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

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Functional results of temporalis fascia versus cartilage tympanoplasty in patients with bilateral chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002817 ◽

2011 ◽

Vol 126 (1) ◽

pp. 22-25 ◽

Cited By ~ 36

Author(s):

K Onal ◽

S Arslanoglu ◽

M Songu ◽

U Demiray ◽

I A Demirpehlivan

Keyword(s):

Standard Deviation ◽

Otitis Media ◽

Chronic Otitis Media ◽

Functional Results ◽

Type I ◽

Temporalis Fascia ◽

Cartilage Tympanoplasty ◽

The Mean ◽

Graft Success ◽

And Cartilage

AbstractObjectives:To compare the functional results of type I tympanoplasty performed with either temporalis fascia or a perichondrium and cartilage island flap, in patients with bilateral chronic otitis media.Method:The study included primary tympanoplasty cases with a subtotal perforation, an intact ossicular chain, a dry ear for at least one month and normal middle-ear mucosa, together with contralateral tympanic membrane perforation. Temporalis fascia tympanoplasty was undertaken in 41 patients, and cartilage tympanoplasty in 39 patients.Results:The graft success rate was 65.9 per cent for the fascia group and 92.3 per cent for the cartilage group. Post-operatively, the mean ± standard deviation air conduction threshold was 28.54 ± 14.20 dB for the fascia group and 22.97 ± 8.37 dB for the cartilage group, while the mean ± standard deviation bone conduction threshold was 11.71 ± 8.50 dB for the fascia group and 7.15 ± 5.56 dB for the cartilage group.Conclusion:In patients with bilateral chronic otitis media, cartilage tympanoplasty seems to provide better hearing results and graft success rates.

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Comparison of Reinforcement Cartilage Graft and Temporalis Fascia Graft in Type 1 Tympanoplasty

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v27i2.56355 ◽

2021 ◽

Vol 27 (2) ◽

pp. 104-110

Author(s):

Md Mainul Islam ◽

Kanu Lal Saha ◽

Harun Ar Rashid Talukder ◽

Md Khalid Mahmud ◽

Riashat Azim Majumder ◽

...

Keyword(s):

Tympanic Membrane ◽

Middle Ear ◽

Uptake Rate ◽

Cartilage Graft ◽

Temporalis Fascia ◽

Hearing Gain ◽

Type 1 Tympanoplasty ◽

Fascia Graft ◽

Cartilage Tympanoplasty

Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middle ear cleft characterized by ear discharge and perforation. It is the commonest ear problem in adult and children. Most common presenting symptoms are ear discharge, mild to severe hearing loss, sometimes tinnitus even vertigo. Treatment of COM is mainly operative. Inactive mucosal variety of COM presents with the perforation in tympanic membrane with non-inflamed middle ear mucosa. The treatment of inactive mucosal variety of COM is Type 1tympanoplasty. It can be done by conventional temporalis fascia or cartilage graft. Both have some merits and demerits. Objective: To compare the the outcomes between reinforcement cartilage graft and temporalis fascia graft in type -1 tympanoplasty. Methods: 86 (43 patients in each group) patients with COM (inactive mucosal) who were admitted in the department of Otolaryngology – Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2018 to June 2019, and had fulfilled the inclusion and exclusion criteria were selected for the study. History, examinations, investigations were done. All patients underwent type 1 tympanoplasty. Prior to surgery relevant investigations were done and informed written consent was taken from all patients. In Group-A reinforcement cartilage tympanoplasty cases and in Group-B temporalis fascia tympanoplasty cases were placed. Post-operative graft uptake rate and hearing gain were compared in two groups Results: The surgical outcomes between reinforcement cartilage tympanoplasty in comparison with temporalis fascia tympanoplasty showed no significant difference of graft uptake rate and hearing gain. Conclusion: Cartilage tympanoplasty has been practised for reconstruction of perforated tympanic membrane in COM since long with variable results. Graft uptake rate in cartilage reinforcement is comparatively better than temporalis fascia graft. So, reinforcement cartilage graft can be adopted as an alternative to temporalis fascia graft in type- I tympanoplasty. Bangladesh J Otorhinolaryngol 2021; 27(2): 104-110

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Outcomes of endoscopic transcanal type 1 cartilage tympanoplasty

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-019-05636-w ◽

2019 ◽

Vol 276 (12) ◽

pp. 3295-3299 ◽

Cited By ~ 5

Author(s):

Doğukan Özdemir ◽

Abdulkadir Özgür ◽

Gökhan Akgül ◽

Mehmet Çelebi ◽

Dursun Mehmet Mehel ◽

...

Keyword(s):

Cartilage Tympanoplasty

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

Ear Nose & Throat Journal ◽

10.1177/0145561317096010-1121 ◽

2017 ◽

Vol 96 (10-11) ◽

pp. 419-432 ◽

Cited By ~ 2

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.

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The practices and philosophies of cartilage tympanoplasty in difficult and challenging circumstances: audiological and morphological perspectives

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20210171 ◽

2021 ◽

Vol 7 (2) ◽

pp. 358

Author(s):

Apoorva Kumar Pandey ◽

Ajaz U. Haq ◽

Sharad Hernot ◽

Madhuri Kaintura ◽

Aparna Bhardwaj ◽

...

Keyword(s):

Success Rate ◽

Pure Tone ◽

Randomized Study ◽

Chronic Otitis Media ◽

Functional Results ◽

Pure Tone Average ◽

Cartilage Tympanoplasty ◽

The Difference ◽

Graft Success ◽

Hearing Outcomes

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 hearing outcomes. Results: Anatomical success rate in this series was 94.36%. The overall mean pre- and post- operative pure tone average air-bone gap (PTA-ABG) were 31.33±10.41 dB and 19.55±12.04 dB, respectively and the difference was statistically significant (p<0.05). Best take up rates were observed in atelectatic and tympanosclerotic group i.e., 100% and 96.55% respectively.Conclusions: This study discusses the results of cartilage tympanoplasty in specifically indicated seven situation and reveals good anatomic results in each group (minimum success rate was 86.66% in wet ears) and statistically significant differences in mean pre- and post op PTA-ABG in groups except cholesteatoma and wet ear group.

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Transcanal Endoscopic Type 1 Cartilage Tympanoplasty in Children

Turkish Archives of Otorhinolaryngology ◽

10.5152/tao.2019.4515 ◽

2019 ◽

Vol 57 (4) ◽

pp. 197-200

Author(s):

Dogukan Ozdemir ◽

◽

Abdulkadir Ozgur ◽

Gokhan Akgul ◽

Mehmet Celebi ◽

...

Keyword(s):

Cartilage Tympanoplasty

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Comparison of Endoscopic Tympanoplasty with Microscopic Tympanoplasty

Journal of Rawalpindi Medical College ◽

10.37939/jrmc.v24i4.1481 ◽

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.

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