Comparison of Temporalis Fascia and Transcanal Composite Chondroperichondrial Tympanoplasty Techniques.

The purpose of this study was to compare the success rates and hearing outcomes of transcanal composite chondroperichondrial cartilage graft with that of underlay temporal muscle fascia (TMF) graft for myringoplasty. In this retrospective study, the medical records of patients who underwent type 1 myringoplasty between September 2015 and February 2018 at Otorhinolaryngology Department of Erzurum Ataturk University were reviewed. Demographic properties, preoperative otological findings, preoperative pure ton audiogram findings, postoperative pure ton audiogram findings, and duration of surgeries were reviewed from medical records. The patients with lack of one or more of these information at medical records or lost to at least 3 months of follow-up were excluded from the study. According to the graft material used in the operation, the patients were divided into 2 groups. The patients operated with cartilage graft by transcanal composite chondropericondrial cartilage graft myringoplasty (TCM) technique was regarded as first group, while patients operated with temporal fascia was regarded as the second group (TMF). Both groups were compared according to preoperative and postoperative air-bone gap (ABG), graft acceptance rate, and duration of operation using SPSS version 20.0 software. A total of 113 patients whose medical records met the inclusion criteria were included in the study. Of these, 59 underwent TCM and 54 underwent TMF myringoplasty. Tympanic membrane perforation closure success rate was higher in the cartilage group (94.9%) than in the fascia group (83.3%; P = .046). In the former, preoperative and postoperative ABG was 19.5 ± 5 and 10.8 ± 4.8 dB, respectively. In the latter, the corresponding values were 20.7 ± 5.4 and 11.5 ± 5.4 dB, respectively (P < .05). Duration of surgery was 29.5 ± 3.4 minutes in the TCM group and 61.5 ± 6.0 minutes in the TMF group (P < .05). Transcanal cartilage myringoplasty could be considered as an appropriate surgical option because of its simplicity, shorter operation time, and rapid patient recovery, with no significant difference in terms of hearing outcomes compared to temporal fascia.

Endoscopic transcanal versus conventional microscopic tympanoplasty in treatment of anterior tympanic membrane perforations.

PURPOSE: To compare the surgical outcomes of endoscopic transcanal tympanoplasty (ETT) and conventional microscopic tympanoplasty (CMT) in repairing anterior tympanic membrane perforations (ATMPs). METHODS: We retrospectively analyzed the graft success rate, hearing outcomes, operative time, hospitalization period and complications in patients who underwent ETT and CMT between October 2015 and July 2018. In addition, the authors investigated whether anterior canal wall protrusion (ACWP) affects the graft success rate and operative time. RESULTS: The graft success rates for ETT and CMT were 93.7% (30 out of 32 patients) and 91.4% (32 out of 35 patients), respectively (p = 0.640). There was no significant relationship between ACWP and graft success rates in either the endoscopic (p = 0.685) and microscopic (p = 0.894) group. The mean operative time was significantly shorter in the ETT group (37.2 ± 3.1 min) than in the CMT group (52.9 ± 9.2 min) (p < 0.001). Regarding operative time, there was no statistically significant difference between patients with and without ACWP (38.3 versus 36.3 min, respectively (p = 0.124)) in the ETT group. However, the mean operative time of patients with ACWP in the CMT group was significantly longer than patients without ACWP [62.3 versus 48.8 min, respectively (p < 0.001)]. CONCLUSIONS: ETT offering fewer complication rates and shorter duration of surgery may serve as a reasonable alternative to CMT in repairing ATMPs, with comparable graft success rates.

Boomerang-Shaped Chondro-Perichondral Graft Versus Temporalis Muscle Fascia Graft: Which One is to be Trusted?

The aim of this study was to compare anatomical and audiological results of boomerang-shaped chondroperichondrial graft (BSCPG) with temporal muscle fascia in type 1 tympanoplasties. Sixty-eight patients in BSCPG group and 54 patients in fascia group were evaluated. Otomicroscopic examination was done periodically till 24 months as for graft perforation, lateralization and retraction and mean air conduction threshold and airbone gap values were measured. At long term controls, in BSCPG group, rates of neomembrane, perforation, retraction and lateralization were 91.17 % (n = 62), 8.82 % (n = 6), 4.41 % (n = 3) and 0 % (n = 0), respectively. In fascia group, the corresponding rates were 79.62 % (n = 43), 20.37 % (n = 11), 12.96 % (n = 7) and 3.7 % (n = 2), respectively. In both groups, mean postoperative PTA and ABG values were significantly better while postoperative same values were significantly different between groups (p = 0.044 and 0.032, respectively). Compared to fascia, BSCPG is an ideal grafting technique in the repair of tympanic membrane perforations.

Surgical success of boomerang-shaped chondroperichondrial graft in pediatric chronic otitis media cases.

OBJECTIVES: To reveal the success of boomerang-shaped chondroperichondrial graft (BSCPG) in pediatric chronic otitis media cases. METHODS: A total of 43 pediatric patients (age 7-16 years) who had undergone type 1 tympanoplasty with the diagnosis of chronic otitis media between March 2010 and March 2013 were included in this retrospective study. The main outcome measures were the graft success rate and level of hearing improvement. RESULTS: Graft intake success rate was 90.7%. Mean preoperative and postoperative air-bone gap values were 20.51 ± 4.34 dB SPL and 9.32 ± 5.64 dB SPL, respectively (p < 0.001). Mean preoperative and postoperative pure tone average values were 28.6 ± 3.52 and 12.24 ± 5.22 respectively (p < 0.001). Air-bone gap was improved to ≤ 10 dB in 38 (88.37%) patients during the postoperative period. CONCLUSIONS: Boomerang-shaped chondroperichondrial grafting technique seems to be a successful alternative in the management of pediatric chronic otitis media cases. It has relatively higher grade graft success rate.