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. 2020 Jul-Aug;86(4):483-489.
doi: 10.1016/j.bjorl.2019.06.014. Epub 2019 Jul 27.

Comparison of temporal muscle fascia and tragal cartilage perichondrium in endoscopic type 1 tympanoplasty with limited elevation of tympanomeatal flap

Kadir Özdamar  1 , Alper Sen  2
Affiliations

Comparison of temporal muscle fascia and tragal cartilage perichondrium in endoscopic type 1 tympanoplasty with limited elevation of tympanomeatal flap

Kadir Özdamar et al. Braz J Otorhinolaryngol. 2020 Jul-Aug.

Abstract
in English, Portuguese

Introduction: Elevation of tympanomeatal flap is one of the basic steps of tympanoplasty. A satisfactory level of anatomic and functional success can be achieved by using different grafts with limited tympanomeatal flap elevation.

Objectives: We aimed to compare the anatomic and functional success of tragal cartilage perichondrium and temporal muscle fascia in cases of endoscopic type 1 tympanoplasty performed with limited tympanomeatal flap elevation.

Methods: In total, 81 cases (33 females, 48 males, mean age 22.1 ± 10.1 years, interval 18-49 years) which underwent transcanal endoscopic type 1 tympanoplasty with limited elevation of tympanomeatal flap were included the present study. All cases were divided into two groups as tragal cartilage perichondrium (group A) and temporal muscle fascia (group B). The comparison of the groups were made considering the pre- and postoperative air-bone gap and the tympanic membrane status.

Results: There was no statistically significant difference between Group A and Group B in preoperative and in postoperative air-bone gap values (p = 0.608 and 0.529, respectively). In Group A and B, postoperative air-bone gap values demonstrated significant decrease compared to the preoperative values (p = 0.0001). Group A and group B did not demonstrate significant differences between postoperative improvements of air-bone gap values (p = 0.687). Graft retention success was 92.6% in group A while it was 90.0% in group B. There was no statistically significant difference between the groups in terms of graft retention success (p = 0.166).

Conclusion: In accordance with the results of this study, we believe that both tragal cartilage perichondrium and temporal muscle fascia, and also in limited tympanomeatal flap elevation in endoscopic tympanoplasty are all eligible for result in safe and successful surgery.

Introdução: O descolamento do retalho timpanomeatal é uma das etapas básicas da timpanoplastia. Um nível satisfatório de sucesso na restauração anatômica e funcional pode ser alcançado com o uso de diferentes enxertos e descolamento limitado do retalho timpanomeatal.

Objetivos: Comparar os resultados anatômicos e funcionais entre o uso de pericôndrio de cartilagem tragal e de fáscia do músculo temporal em timpanoplastias endoscópicas tipo 1 feitas com descolamento limitado do retalho timpanomeatal.

Método: Foram incluídos no estudo 81 pacientes (33 mulheres, 48 ​​homens, média de 22,1 ± 10,1 anos, variação de 18-49 anos), submetidos a timpanoplastia endoscópica transcanal tipo 1 com descolamento limitado do retalho timpanomeatal. Todos os casos foram divididos em dois grupos: pericôndrio da cartilagem tragal (grupo A) e fáscia do músculo temporal (grupo B). Na comparação dos grupos consideraram-se o gap aéreo-ósseo, pré e pós-operatório e a condição da membrana timpânica.

Resultados: Não houve diferença estatisticamente significante entre os grupos A e B no pré e pós-operatório (p = 0,608 e 0,529, respectivamente). Nos grupos A e B, os valores do gap aéreo-ósseo no pós-operatório demonstraram redução significante em relação aos valores pré-operatórios (p = 0,0001). Os grupos A e B não demonstraram diferenças significantes entre as medidas pré e pós-operatórias dos valores dos gaps (p = 0,687). O sucesso da retenção do enxerto foi de 92,6% no grupo A, enquanto no grupo B foi de 90,0%, não ocorreu diferença estatisticamente significante entre os grupos (p = 0,166).

Conclusão: De acordo com os resultados deste estudo, acreditamos que tanto o pericôndrio da cartilagem tragal como a fáscia do músculo temporal, usados com descolamento limitado do retalho timpanomeatal na timpanoplastia endoscópica, são elegíveis para uma cirurgia segura e bem-sucedida.

Keywords: Endoscopic tympanoplasty; Fáscia do músculo temporal; Perichondrium; Pericôndrio; Retalho timpanomeatal; Temporal muscle fascia; Timpanoplastia endoscópica; Tympanomeatal flap.

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Figures

Figure 1
Figure 1
(A–E) Preoperative and postoperative surgical stages of Group A. (A) Preoperative view of tympanic membran perforation. (B) After reviving the perforation edges. (C) Limited tympanomeatal fleb elevation. (D) The grafts were placed appropriately with the over-underlay technique. (E) Tympanic membran view of postoperative 6th month).
Figure 2
Figure 2
(A–E) Preoperative and postoperative surgical stages of Group B. (A) Preoperative view of tympanic membran perforation. (B) After reviving the perforation edges. (C) Limited tympanomeatal fleb elevation. (D) The grafts were placed appropriately with the over-underlay technique. (E) Tympanic membran view of postoperative 6th month).
Figure 3
Figure 3
Comparison ABG between two groups.
See this image and copyright information in PMC

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