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Endoscopic "Push-Trough" Technique Cartilage Myringoplasty in Anterior Tympanic Membrane Perforations.

Celik H, Samim E, Oztuna D - Clin Exp Otorhinolaryngol (2015)

Bottom Line: Graft success rate was 87.5% in this study.Preoperative mean air conduction hearing threshold was 25.9 dB, and the mean air-bone gap was 11.9 dB while these values improved to 19.5 dB and 5.3 dB respectively in the postoperative period.The analysis of preoperative and postoperative mean air conduction thresholds and air bone gap values of the patients revealed statistically significant differences.

View Article: PubMed Central - PubMed

Affiliation: Otorhinolaryngology Clinic, Ministry of Health Ankara Education and Research Hospital, Ankara, Turkey.

ABSTRACT

Objectives: To evaluate endoscopic push-through technique cartilage myringoplasty results.

Methods: This prospective study was performed on patients with anterior tympanic membrane perforations and endoscopic push-through technique cartilage myringoplasty was performed between 2011 and 2013. The patients who did not have any cholesteatoma or otorrhea in the previous 3 months, and had an air bone gap ≤25 dB in their preoperative audiograms were included in the study. They were followed up with endoscopic examination and audiograms at 2nd, 6th, 12th, and 24th postoperative months. Pure tone averages were calculated at 0.5, 1, 2, and 4 kHz frequencies.

Results: Of 32 patients, 19 were females and 13 were males. The mean age was 40.3 years (range, 16 to 62 years), and the mean follow-up period was 12.4 months (range, 6 to 24 months). Graft success rate was 87.5% in this study. Preoperative mean air conduction hearing threshold was 25.9 dB, and the mean air-bone gap was 11.9 dB while these values improved to 19.5 dB and 5.3 dB respectively in the postoperative period. The mean hearing gain was 6.4 dB. The analysis of preoperative and postoperative mean air conduction thresholds and air bone gap values of the patients revealed statistically significant differences.

Conclusion: Underlay cartilage myringoplasty with endoscopic push-through technique in anterior quadrant tympanic membrane perforations is an effective, minimally invasive and feasible method.

No MeSH data available.


Related in: MedlinePlus

Postoperative endoscopic appearances of the patients. (A) The appearance of vascularization on the cartilage graft at second postoperative month, left ear; (B) The appearance of the cartilage after one year postoperatively, right ear; (C) The appearance of cartilage anterior to malleus manibrium, and the vascular structures feeding it at postoperative 6th month, right ear; (D) The appearance of the pearl cholesteatoma (white arrow) placed at inferior-posterior end of the intact cartilage graft at postoperative 6th month, right ear.
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Figure 4: Postoperative endoscopic appearances of the patients. (A) The appearance of vascularization on the cartilage graft at second postoperative month, left ear; (B) The appearance of the cartilage after one year postoperatively, right ear; (C) The appearance of cartilage anterior to malleus manibrium, and the vascular structures feeding it at postoperative 6th month, right ear; (D) The appearance of the pearl cholesteatoma (white arrow) placed at inferior-posterior end of the intact cartilage graft at postoperative 6th month, right ear.

Mentions: Graft success rate was 87.5%. In one patient with EPTCM, it was seen that the cartilage graft slipped from the superior edge of the perforation inferiorly, and covered 50% of the primary perforation three weeks after surgery. Fat myringoplasty was preformed in postoperative second month in this patient. The perforation was seen to be closed at postoperative 4th month. In one patient, a 1-mm-sized perforation was seen at the posterior edge of the perforation at postoperative 2nd month. This perforation was seen to be closed spontaneously at postoperative 6th month. These two patients were classified as graft failure in the study. In one patient, a pearl cholesteatoma was seen at the posterior edge of the perforation, and it was removed by the endoscopic approach. Fig. 4 demonstrates the pearl cholesteatoma, and the postoperative endoscopic appearances of some patients.


Endoscopic "Push-Trough" Technique Cartilage Myringoplasty in Anterior Tympanic Membrane Perforations.

Celik H, Samim E, Oztuna D - Clin Exp Otorhinolaryngol (2015)

Postoperative endoscopic appearances of the patients. (A) The appearance of vascularization on the cartilage graft at second postoperative month, left ear; (B) The appearance of the cartilage after one year postoperatively, right ear; (C) The appearance of cartilage anterior to malleus manibrium, and the vascular structures feeding it at postoperative 6th month, right ear; (D) The appearance of the pearl cholesteatoma (white arrow) placed at inferior-posterior end of the intact cartilage graft at postoperative 6th month, right ear.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553352&req=5

Figure 4: Postoperative endoscopic appearances of the patients. (A) The appearance of vascularization on the cartilage graft at second postoperative month, left ear; (B) The appearance of the cartilage after one year postoperatively, right ear; (C) The appearance of cartilage anterior to malleus manibrium, and the vascular structures feeding it at postoperative 6th month, right ear; (D) The appearance of the pearl cholesteatoma (white arrow) placed at inferior-posterior end of the intact cartilage graft at postoperative 6th month, right ear.
Mentions: Graft success rate was 87.5%. In one patient with EPTCM, it was seen that the cartilage graft slipped from the superior edge of the perforation inferiorly, and covered 50% of the primary perforation three weeks after surgery. Fat myringoplasty was preformed in postoperative second month in this patient. The perforation was seen to be closed at postoperative 4th month. In one patient, a 1-mm-sized perforation was seen at the posterior edge of the perforation at postoperative 2nd month. This perforation was seen to be closed spontaneously at postoperative 6th month. These two patients were classified as graft failure in the study. In one patient, a pearl cholesteatoma was seen at the posterior edge of the perforation, and it was removed by the endoscopic approach. Fig. 4 demonstrates the pearl cholesteatoma, and the postoperative endoscopic appearances of some patients.

Bottom Line: Graft success rate was 87.5% in this study.Preoperative mean air conduction hearing threshold was 25.9 dB, and the mean air-bone gap was 11.9 dB while these values improved to 19.5 dB and 5.3 dB respectively in the postoperative period.The analysis of preoperative and postoperative mean air conduction thresholds and air bone gap values of the patients revealed statistically significant differences.

View Article: PubMed Central - PubMed

Affiliation: Otorhinolaryngology Clinic, Ministry of Health Ankara Education and Research Hospital, Ankara, Turkey.

ABSTRACT

Objectives: To evaluate endoscopic push-through technique cartilage myringoplasty results.

Methods: This prospective study was performed on patients with anterior tympanic membrane perforations and endoscopic push-through technique cartilage myringoplasty was performed between 2011 and 2013. The patients who did not have any cholesteatoma or otorrhea in the previous 3 months, and had an air bone gap ≤25 dB in their preoperative audiograms were included in the study. They were followed up with endoscopic examination and audiograms at 2nd, 6th, 12th, and 24th postoperative months. Pure tone averages were calculated at 0.5, 1, 2, and 4 kHz frequencies.

Results: Of 32 patients, 19 were females and 13 were males. The mean age was 40.3 years (range, 16 to 62 years), and the mean follow-up period was 12.4 months (range, 6 to 24 months). Graft success rate was 87.5% in this study. Preoperative mean air conduction hearing threshold was 25.9 dB, and the mean air-bone gap was 11.9 dB while these values improved to 19.5 dB and 5.3 dB respectively in the postoperative period. The mean hearing gain was 6.4 dB. The analysis of preoperative and postoperative mean air conduction thresholds and air bone gap values of the patients revealed statistically significant differences.

Conclusion: Underlay cartilage myringoplasty with endoscopic push-through technique in anterior quadrant tympanic membrane perforations is an effective, minimally invasive and feasible method.

No MeSH data available.


Related in: MedlinePlus