Wheel-shaped cartilage-perichondrium composite graft for the prevention of retraction pocket development

Conclusion. Our technique can decrease the formation of retraction pockets and improve hearing function. The wheel-shaped cartilage-perichondrium composite graft (Wheel CPCG) can be considered a good material for a drum graft, and it is easy to insert a ventilation tube, in case of initial drum retraction. Objective. The purpose of this study was to introduce the novel surgical technique of a Wheel CPCG with one-stage ossiculoplasty to prevent a retraction pocket and subsequent cholesteatoma after intact canal wall tympanomastoidectomy. Patients and methods. A total of 47 patients were reviewed; 43 cases were selected for audiologic testing. The results of operations were evaluated by comparing preoperative and postoperative hearing results and postoperative drum findings. Results. A retraction pocket was observed in three cases (6.7%). Slight protrusion of partial ossicular replacement prosthesis (PORP) and lateral healing of drum was observed in one case each, and there were two cases of postoperative infection. The number of cases with an air–bone gap (ABG)<20 dB increased from 9 (23%) cases before operation, to 20 cases (51%) after operation. The ABG average statistically decreased from 30.0 dB to 24.0 dB, and the mean air conduction thresholds decreased from a preoperative level of 47.3 dB to a level of 35.7 dB.

[1]  S. Fernandes.  Composite chondroperichondrial clip tympanoplasty: the triple "C" technique. , 2003, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[2]  D. Mürbe,et al.  Acoustic Properties of Different Cartilage Reconstruction Techniques of the Tympanic Membrane , 2002, The Laryngoscope.

[3]  Matthew J. Gerber,et al.  Hearing Results After Primary Cartilage Tympanoplasty , 2000, The Laryngoscope.

[4]  D. Mürbe,et al.  Experimental investigations of the use of cartilage in tympanic membrane reconstruction. , 2000, The American journal of otology.

[5]  J. Dornhoffer.  Hearing Results with Cartilage Tympanoplasty , 1997, The Laryngoscope.

[6]  J. W. House,et al.  Committee on Hearing and Equilibrium Guidelines for the Evaluation of Results of Treatment of Conductive Hearing Loss ∗ , 1995, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[7]  C. Milewski.  Composite graft tympanoplasty in the treatment of ears with advanced middle ear pathology , 1993, The Laryngoscope.

[8]  R. Levinson.  Cartilage‐perichondrial composite graft tympanoplasty in the treatment of posterior marginal and attic retraction pockets , 1987, The Laryngoscope.

[9]  D. Mikaelian.  Perichondrial‐cartilage island graft in one stage tympano‐ossiculoplasty , 1986, The Laryngoscope.

[10]  E. Chiossone.  "Three cartilages" technique in intact canal wall tympanoplasty to prevent recurrent cholesteatoma. , 1985, The American journal of otology.

[11]  S. E. Kinney.  “How I do it” — otology and neurotology a specific issue and its solution middle ear reconstruction using cartilage and torpr̀ and porpr̀ , 1979 .

[12]  S. E. Kinney.  Middle ear reconstruction using cartilage and TORP and PORP. , 1979, The Laryngoscope.

[13]  V. Goodhill.  Tragal perichondrium and cartilage in tympanoplasty. , 1967, Archives of otolaryngology.

[14]  B. Salén.  MYRINGOPLASTY USING SEPTUM CARTILAGE. , 1964, Acta oto-laryngologica. Supplementum.