Composite Cartilage Island Grafts in Type 1 Tympanoplasty

Abstract

Tympanoplasty is a surgical procedure used for eradicating chronic middle ear infection and for reconstructing hearing in infected ears. Independent from the graft placing technique, the atrophy and the insufficiency of the graft material would be seen.For cases at high risk for failure, such as recurrent perforations, total perforations, and severely atelectatic tympanic membranes, many surgeons have used cartilage as a grafting material because of its increased stability and resistance to negative middle ear pressure. Various cartilage grafting techniques have been described, including the palisade, cartilage island, and cartilage shield.In our study, we investigated audiological and otological outcomes of tympanoplasty type 1 with composite cartilage island grafts. Between 2004 and 2008, 100 cases of composite cartilage island tympanoplasty were identified. A total of 74 patients were attended to in this study. Graft take was evaluated in all patients, and postoperative complications were noted. Hearing results were analyzed by comparing the preoperative and postoperative pure-tone average air-bone gap. Graft take was accomplished in 72 patients (97.29%). There was no graft lateralization or displacement in the middle ear. The mean postoperative pure-tone average air-bone gap improvement was 20.2 dB at 500 Hz, 23.58 dB at 1000 Hz, 22.23 dB at 2000 Hz, and 24.79 at 4000 Hz.Our study indicates that composite cartilage island tympanoplasty has a high degree of reliability and excellent hearing improvement especially in patients at high risk for graft failure.