Skip to main content

Underlay cartilage tympanoplasty: different ways of application of the graft

Abstract

Introduction

The objective of this study was to evaluate underlay tympanoplasty technique of perichondrium cartilage graft according to the position of the graft with respect to the handle of malleus and remnant of tympanic membrane.

Patients and Methods

In all, 150 patients with chronic suppurative otitis media (safe type) underwent tympanoplasty with or without mastoidectomy. The patients were divided into three groups (50 patients in each group). Group I graft was placed medial to the handle of malleus, group II graft was placed at the plane of malleus, group III graft was placed lateral to the malleus between it and remnant of tympanic membrane.

Results

Success rate (graft taken with no residual perforation) in all cases is 98% (147 cases). Success rate in groups I–III is 98% (49 cases), 100% (50 cases) and 96% (48 cases), respectively. There is significant statistical improvement of postoperative pure tone audiogram.

Conclusion

Underlay cartilage tympanoplasty was associated with a high rate of graft taken and good hearing results despite the position of the graft in relation to the handle of malleus.

References

  1. 1

    Callioglu EF, Bercin AS, Kale H, Muderris T, Demirci S, Tuzuner A, Korkmaz MH. Is allergic rhinitis a factor that affects success of tympanoplasty? Acta Medica Cordoba 2016; 59:10–13.

    Google Scholar 

  2. 2

    Sergi B, Galli J, De corso E, Parrilla C, Paludetti G. Overlay versus underlay myringoplasty: report of outcomes considering closure of perforation and hearing function. Acta Otorhinolaryngol Ital 2011; 31:366–371.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. 3

    Rafique M, Farrukh MS, Siddiqui AH. Underlay versus onlay myringoplasty and its outcome: experience at tertiary care hospitals. Pakistan J Otolaryngol 2014; 30:11–14.

    Google Scholar 

  4. 4

    Patil K, Baisakhiya N, Deshmukh PT. Evaluation of different graft material in type 1 tympanoplasty. Indian J Otol 2014; 20:106–114.

    Article  Google Scholar 

  5. 5

    Tos M. Cartilage tympanoplasty methods: proposal of a classification. Otolaryngol Head Neck Surg 2008; 139:747–758.

    Article  Google Scholar 

  6. 6

    Prasad S, Ahlawat B, Kumar A, Agrawal A, Nalksulaha M, Chaudhury N. Cartilage island tympanoplasty: the prespective study of anatomical and audiological results. Indian J Sci Res 2010; 7:103–107.

    Google Scholar 

  7. 7

    Dornhoffer J. Cartilage tympanoplasty: indications, techniques, and outcomes in a 1, 000-patient series. Laryngoscope 2003; 113:1844–1856.

    Article  Google Scholar 

  8. 8

    Vashishth A, Mathur NM, Verma D. Cartilage palisades in type 3 tympanoplasty: functional and hearing results. Indian J Otolaryngol Head Neck Surg 2014; 66:309–313.

    Article  Google Scholar 

  9. 9

    Demirpehlivan IA, Onal K, Arslanogulu S, Songu M, Ciger E, Can N. Comparison of different tympanic membrane reconstruction techniques in type I tympanoplasty. Eur Arch Otorhinolaryngol 2011; 268:471–474.

    Article  Google Scholar 

  10. 10

    Shrestha BL, Amatya RC, Shrestha I, Pokharel M. Comparison of pre and post-operative hearing results in patients undergone modified inlay butterfly cartilage perichondrium myringoplasty. J Rhinol-Otologies 2013; 1:82–86.

    Google Scholar 

  11. 11

    Mendes Neto JA, Neiva FC, Brodskyn F, Palumbo MD, Bittar CV, Petrilli CV, Tasta JR. Plug cartilage tympanoplasty in children. Braz J Otorhinolaryngol 2008; 74:890–895.

    Article  Google Scholar 

  12. 12

    Onal K, Arslanoglu S, Oncel S, Songu M, Kopar A, Demiray U. Perichondrium/cartilage island flap and temporalis muscle fascia in type I tympanoplasty. J Otolaryngol Head Neck Surg 2011; 40:295–299.

    PubMed  Google Scholar 

  13. 13

    Cavaliere M, Mottola G, Pondinelli M, Iemma M. Tragal cartilage in tympanoplasty: anatomic and functional results in 306 cases. Acta Otorhinolaryngol Ital 2009; 29:27–32.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. 14

    Yurttas V, Yakut F, Kutluhan A, Bozdemir K. Preparation and placement of cartilage island graft in tympanoplasty. Braz J Otorhinolaryngol 2014;80:522–526.

    Article  Google Scholar 

  15. 15

    Kulduk E, Dundar R, Soy FK, Guler OK, Yukkaldiran A, Iynen I, Bozkus F. Treatment of large tympanic membrane perforations: medial to malleus versus lateral to malleus. Indian J Otolaryngol Head Neck Surg 2015;67:173–179

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Ahmed Abdel Rahman Abdel Aziz MD.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Aziz, A.A.R.A. Underlay cartilage tympanoplasty: different ways of application of the graft. Egypt J Otolaryngol 34, 194–197 (2018). https://doi.org/10.4103/ejo.ejo_21_17

Download citation

Keywords

  • cartilage tympanoplasty
  • tympanoplasty
  • underlay technique