Cartilage "shield" grafts in revision tympanoplasty

Otol Neurotol. 2008 Apr;29(3):330-3. doi: 10.1097/mao.0b013e318161aae1.

Abstract

Objective: To report our experience with cartilage "shield" grafts in revision tympanoplasty.

Study design: Retrospective chart review at a tertiary referral center. Patients underwent revision tympanoplasties by replacing the entire tympanic membrane with concha cymba cartilage shaped as a shield.

Main outcome measures: Successful graft take was defined as having no perforation, graft retraction, or lateralization. Hearing results were analyzed by comparing the preoperative and postoperative pure-tone average air-bone gap and speech discrimination scores.

Results: Forty-three patients underwent 46 procedures. Graft take was successful in 43 procedures (93.5%). There was no graft lateralization or displacement into the middle ear. An overall postoperative air-bone gap of 25 dB or less was achieved in 22 of the 39 patients (56.4%), and speech discrimination scores remained unchanged.

Conclusion: Cartilage shield tympanoplasty is a reliable procedure for revision tympanoplasty patients, with excellent graft take and significant improvement of hearing.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cartilage / transplantation*
  • Child
  • Cholesteatoma, Middle Ear / diagnosis
  • Cholesteatoma, Middle Ear / surgery*
  • Follow-Up Studies
  • Graft Survival*
  • Hearing
  • Humans
  • Mastoid / surgery
  • Middle Aged
  • Ossicular Prosthesis*
  • Postoperative Complications
  • Pressure
  • Retrospective Studies
  • Secondary Prevention
  • Treatment Outcome
  • Tympanoplasty / methods*