Cartilage tympanoplasty: Indications, techniques, and outcomes in A 1,000‐patient series

摘要: Objectives/Hypothesis: The purpose of this study was to analyze the anatomical and audiologic results in more than 1,000 cartilage tympanoplasties that utilized a logical application several techniques for management difficult ear (cholesteatoma, recurrent perforation, atelectasis). Our hypothesis pathology status ossicular chain should dictate technique used achieve optimal outcome. Study Design: Retrospective clinical patients undergoing tympanoplasty between July 1994 2001. A computerized otologic database patient charts were obtain necessary data. Methods: modification perichondrium/cartilage island flap tympanic membrane reconstruction cases atelectatic ear, high-risk perforation presence an intact chain, association with ossiculoplasty when malleus absent. palisade TM cholesteatoma present. Hearing reported using four-frequency (500, 1,000, 2,000, 3,000 Hz) pure-tone average air-bone gap (PTA-ABG). Student t test statistical comparison. Postoperative complications recorded. Results: During period, patients, which 712 had sufficient data available inclusion. Of these, 636 outcomes analysis. In 220 cases, pre- postoperative PTA-ABGs 26.5 ± 12.6 dB 14.6 8.8 dB, respectively (P < .05). Recurrence seen 8 (3.6%), conductive HL requiring revision 4 (1.8%), 3 (1.4%), postand intraoperative tube insertion 11 (5.0%) 18 ears (8.2%), respectively. 215 21.7 13.5 11.9 9.3 Complications included 9 (4.2%), (1.9%), (1.9%) 6 (2.8%), 98 atelectasis, 20.2 10.9 14.2 10.2 1 (1.0%), loss 2 (2.0%), post- 7 (7.1%) 12 (12%), 103 improve hearing (audiologic), 33.6 9.6 10.1 (11%), (5.8%) Conclusions: Cartilage achieves good utilized. Significant improvement realized each pathological group. allowed us reconstruct anatomic compared traditional reconstructions, have shown high rates retraction failure. cholesteatoma, resulted precise helped reduce recurrence. yielded functional favorably primary techniques. We believe indications (atelectatic perforation) validated by these results.