[Reinforcing tympanoplasty with cartilage mosaic (differences from the palisade technique)]

Abstract

Objectives: To demonstrate the interest of cartilage mosaic tympanoplasty in the reconstruction of the tympanic membrane.

Materials and methods: Retrospective series of 103 patients; the authors analyzed their results after cartilage mosaic tympanoplasty, with a mean follow up of 3.5 years (3 to 7 years). They explain the surgical technique in detail. The average gain was calculated on the difference of the pre-and post-operative thresholds in air conduction on the four frequencies 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz.

Results: The authors detail and analyze their anatomical and audiologic results. The total rate of closing of the tympanic membrane is 93.2%, accounting for 96 perforations closed among 103. A tympanic retraction sitting apart from the reinforced zone was noted in 0.97%, representative only one case of 103. Then the total rate of success is 92.23%, representing 8 failures of 103. The average pre- and post-operative air bone gap were 26.5 dB and 14.6 dB. The average gain was 12.5 dB (extremes of 0 dB to 40 dB).

Conclusion: The authors show the great reliability of cartilage mosaic tympanoplasty to reconstruct the tympanic membrane. They widen the indications with all types of tympanoplasties. Especially with the recurrent perforations, and the perforations evolving in an inflammatory context and/or dysfunction of the Eustation tube. Their results show a major interest to use this technique in the anterior and inferior perforations, and whatever the ossicular chain status.