Miringoplastia con injerto doble medial y lateral / Double medial and lateral graft in myringoplasty

Objetivos: Se describe la técnica quirúrgica del injerto doble medial y lateral de fascia autóloga, sus indicaciones y resultados. Material y método: Se estudian las características preoperatorias y al año de la intervención de 100 casos intervenidos de miringoplastia con la técnica de injerto doble medial y lateral de fascia autóloga. Se analizan los resultados anatómicos y funcionales. Resultados: Los resultados se valoran al año de la intervención. En el 95% de los casos conseguimos el cierre de la perforación. La incidencia de persistencia de las perforaciones es del 12,5% en los niños menores de 10 años y del 2,5% en niños mayores de 10 años y adultos. Las complicaciones son un 4% de perlas epiteliales con engrosamiento del neotímpano, un 1% de retracciones del neotímpano y un 3% de epitelitis que se resuelven con tratamiento médico tópico. La recuperación auditiva es del 85% de cierres del UDA medio a menos de 20 dB (el 38% a menos de 10dB y el 47% entre 10 y 20 dB). Se analizan las posibles causas del cierre incompleto del UDA, posiblemente relacionados con fibrosis y esclerosis de los restos timpánicos y/o la cadena osicular. Conclusiones: Se concluye que esta metodología nos proporciona los mejores resultados en comparación con otras que hemos utilizado y hemos relegado a situaciones muy específicas atendiendo al tamaño y localización de la perforación

Objectives: A surgical technique for a double medial and lateral overlay autologous fascia graft myringoplasty is described in this paper along with its indications and results. Material and method: The presurgical and one year post surgery characteristics are analyzed for 100 cases with the double medial and lateral overlay autologous fascia graft technique. The anatomical and functional results are analyzed. Results: The results are analyzed one year post surgery. The probabilities of obtaining a graft take using this methodology are 95%. The incidence of persistence of the perforations is 12.5% in children under 10 and 2.5% in children over ten years of age and adults. The complications are 4% of epithelial pearls with blunting of the neo-tympanum, 1% of retractions and 3% of epithelitis which is resolved with a topical medical treatment. The average residual air/bone gap is less than 20 dB in 85% of the cases. Less than 10 dB in 38%, and between 10 and 20 dB in 47%. The causes for incomplete closure of the gap are analyzed; possibly related to fibrosis and sclerosis of the tympanic remnants and/or the ossicular chain. Conclusions: It is concluded that this methodology provides the best results in comparison with other methods we have used and have set aside for very specific situations related to the size and location of the perforation

Double medial and lateral graft in myringoplasty. / Miringoplastia con injerto doble medial y lateral.

OBJECTIVES: A surgical technique for a double medial and lateral overlay autologous fascia graft myringoplasty is described in this paper along with its indications and results. MATERIAL AND METHOD: The presurgical and one year post surgery characteristics are analyzed for 100 cases with the double medial and lateral overlay autologous fascia graft technique. The anatomical and functional results are analyzed. RESULTS: The results are analyzed one year post surgery. The probabilities of obtaining a graft take using this methodology are 95%. The incidence of persistence of the perforations is 12.5% in children under 10 and 2.5% in children over ten years of age and adults. The complications are 4% of epithelial pearls with blunting of the neo-tympanum, 1% of retractions and 3% of epithelitis which is resolved with a topical medical treatment. The average residual air/bone gap is less than 20dB in 85% of the cases. Less than 10dB in 38%, and between 10 and 20dB in 47%. The causes for incomplete closure of the gap are analyzed; possibly related to fibrosis and sclerosis of the tympanic remnants and/or the ossicular chain. CONCLUSIONS: It is concluded that this methodology provides the best results in comparison with other methods we have used and have set aside for very specific situations related to the size and location of the perforation.