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. 2014 Nov-Dec;80(6):522-6.
doi: 10.1016/j.bjorl.2014.08.007. Epub 2014 Aug 28.

Preparation and placement of cartilage island graft in tympanoplasty

Veysel Yurttas  1 , Fatih Yakut  2 , Ahmet Kutluhan  3 , Kazım Bozdemir  3
Affiliations

Preparation and placement of cartilage island graft in tympanoplasty

Veysel Yurttas et al. Braz J Otorhinolaryngol. 2014 Nov-Dec.

Abstract
in English, Portuguese

Introduction: Cartilage graft tympanoplasty has a better success rate in the treatment of chronic otitis media if regularly prepared and placed.

Objective: To prepare cartilage island material and evaluate its effect on the success rate of tympanoplasty.

Methods: The medical records of 87 patients (48 males and 39 females; mean age, 27.3±11.2 years; range, 14-43 years) with chronic otitis media without cholesteatoma who underwent intact canal-wall-up tympanoplasty and revision surgery between December of 2007 and October of 2011 were retrospectively evaluated. Surgery was performed under general anesthesia via a retroauricular approach.

Results: The overall success rate of this technique was 93% in terms of perforation closure. No graft lateralization or displacement into the middle ear occurred. The overall average preoperative air bone gap was 37.27±12.35 dB, and the postoperative air bone gap was 27.58±9.84 dB. The mean postoperative follow-up period was 15.3 months (range: 7-21 months).

Conclusion: If cartilage graft is properly prepared and placed, cartilage graft tympanoplasty appears to provide better success rates and hearing results.

Introducão: A timpanoplastia de enxerto de cartilagem tem uma melhor taxa de sucesso no tratamento de otite média crónica se for preparada e colocada de forma sistemática.

Objetivo: Preparar o material de enxerto de cartilagem “em ilha” e avaliar o seu impacto na taxa de sucesso da timpanoplastia.

Método: Os registos médicos de 87 pacientes (48 do sexo masculino e 39 do sexo feminino; idade média 27.3 ± 11.2 anos; intervalo 14-43 anos) com otite média crónica sem colesteatoma que foram submetidos a timpanoplastia de levantamento de parede do canal intacto e cirurgia de revisão entre Dezembro 2007 e Outubro 2011 foram avaliados em retrospetiva. A cirurgia foi realizada sob anestesia geral através de uma abordagem retro auricular.

Resultados: A taxa de sucesso global da nossa técnica foi de 93% em termos de sutura da perfuração. Não ocorreu lateralização do enxerto nem deslocação para o ouvido médio. O intervalo aéreo-ósseo pré-operatório médio global (ABG) era de 37.27 ± 12.35 dB e o ABG pós-operatório era de 27.58 ± 9.84 dB. O período médio de seguimento pós-operatório era de 15.3 meses (intervalo 7-21 meses).

Conclusão: Se o enxerto de cartilagem for devidamente preparado e colocado, a Timpanoplastia de enxerto de cartilagem apresenta melhores taxas de sucesso e resultados ao nível da audição.

Keywords: Cartilagem auricular; Ear cartilage; Otorhinolaryngologic surgical procedures; Perfuração da membrana timpânica; Procedimentos cirúrgicos otorrinolaringológicos; Tympanic membrane perforation.

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Figures

Figure 1
Figure 1
Conchal island graft.
Figure 2
Figure 2
Picture of anatomic result 12 months after the operation.
Figure 3
Figure 3
Perforation between remnant tympanic membrane and cartilage part of the graft seven months after the operation.
See this image and copyright information in PMC

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