Endaural Over-Underlay Cartilage Tympanoplasty for Repair of Dry Subtotal Perforations

Çetin Y. S., Erdem M. Z.

ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, vol.130, no.12, pp.1345-1350, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 130 Issue: 12
  • Publication Date: 2021
  • Doi Number: 10.1177/00034894211007218
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, Linguistics & Language Behavior Abstracts, MEDLINE, MLA - Modern Language Association Database, Veterinary Science Database
  • Page Numbers: pp.1345-1350
  • Keywords: cartilage grafts, underlay cartilage tympanoplasty, miscellaneous, tragal cartilage graft, large, subtotal perforation, graft integration, MIDDLE-EAR, PERICHONDRIUM, FASCIA, GRAFT
  • Van Yüzüncü Yıl University Affiliated: Yes


Objectives: We explored the auditory and anatomical success of grafting when the cartilage perichondrium (CP) was prepared using two different methods. Methods: Patients with subtotal or total perforation underwent tympanoplasty with a CP graft. A V-shaped groove for the handle of the malleus was prepared for CP grafts in patients in group 1. Patients in group 2 did not have a groove on the graft. The anatomical success of the graft was evaluated as success, partial success, or failure. Results of auditory evaluations were compared between the two groups. Results: A total of 195 patients were included in the study. The total CP graft integration rate was 96% for both groups. Significant changes were detected in all hearing criteria evaluated 12 months after surgery compared to the preoperative period (P < .05). There were no significant differences between the groups in terms of the relationship between graft technique and postoperative hearing results. However, rates of partial success were significantly higher for group 1 than group 2 (P = .033). Conclusion: Cartilage slice support offers an extremely reliable method for reconstruction of tympanic membrane in cases of high-risk perforation. Partial failures are rare, but when they occur, they most often involved anterior graft medialization. When a piece of cartilage is removed at the malleus interface there may be a higher rate of partial failure.