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‘Umbrella’ graft tympanoplasty

Published online by Cambridge University Press:  19 January 2010

M Malhotra
M Malhotra*
Affiliation:
Department of Otorhinolaryngology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India
*
Address for correspondence: Dr Manu Malhotra, R-19, LLRM Medical College, Garh Road, Meerut, Uttar Pradesh, India, Pin 250001. E-mail: manumalhotrallrm@gmail.com
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Abstract

Objectives:

Tympanoplasty continues to pose a challenge in developing countries, where treatment cost and lack of compliance with second stage surgery are often important factors in determining the surgical strategy. This study aimed to determine the effectiveness of the newly developed, ‘umbrella’ autograft.

Materials and methods:

In 22 patients suffering chronic suppurative otitis media, in whom the incus and stapes suprastructure were found to be absent during surgery, reconstruction was achieved using cartilage-malleus umbrella graft assembly. Six-month post-operative results were evaluated on the basis of average hearing gain, measured at 0.5, 1, 2 and 3 kHz.

Results:

At six months post-operatively, 77.3 per cent of patients showed hearing improvement. Audiography at this time indicated significant improvement (p < 0.001), suggesting that this hearing gain may stand the test of time.

Conclusion:

Umbrella graft tympanoplasty appears to be a promising technique in terms of cost-effectiveness and the autologous nature of implant materials.

Keywords

Middle EarOssiculoplastyAutograftCartilageTympanoplasty
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 4 , April 2010 , pp. 377 - 381
Copyright
Copyright © JLO (1984) Limited 2010

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References

1 Beutner, D, Luers, JC, Huttenbrink, KB. Cartilage ‘shoe’ technique for stabilisation of titanium total ossicular replacement prosthesis at centre of stapes footplate. J Laryngol Otol 2008;122:682–6CrossRefGoogle ScholarPubMed
2 Dalchow, CV, Grun, D, Stupp, HF. Reconstruction of the ossicular chain with ossicular chain implants. Otolaryngol Head Neck Surg 2001;125:628–30CrossRefGoogle ScholarPubMed
3 Ho, SY, Battista, RA, Weit, RJ. Early results with titanium implants. Otol Neurotol 2003;24:149–52CrossRefGoogle Scholar
4 Krueger, WW, Feghali, JG, Shelton, C, Green, JD, Beatty, CW, Wilson, DF et al. Preliminary ossicuplasty results using the Kurz titanium prosthesis. Otol Neurotol 2002;23:836–9CrossRefGoogle Scholar
5 Yung, M. Cartilage tympanoplasty: literature review. J Laryngol Otol 2008;122:663–72CrossRefGoogle ScholarPubMed
6 Heermann, J. Autograft tragal and conchal palisade cartilage and perichondrium in tympanomastoid reconstruction. Ear Nose Throat J 1992;71:344–9CrossRefGoogle ScholarPubMed
7 Brockman, SJ. Cartilage graft tympanoplasty type III. Laryngoscope 1965;75:1452–61CrossRefGoogle Scholar
8 Goodhill, V. Tragal perichondrium and cartilage in tympanoplasty. Arch Otolaryngol 1967;85:480–91CrossRefGoogle ScholarPubMed
9 Tjellstrom, A and Alberktsson, T. A five-year fallow up of preformed, autologus assicles in tympanoplasty. J Laryngol Otol 1985;99:729–33CrossRefGoogle Scholar
10 Elwany, S. Histochemical study of cartilage autografts in tympanoplasty. J Laryngol Otol 1985;99:637–42CrossRefGoogle ScholarPubMed
11 Lacosta, JL, Infante, JC, Pisón, F. Functional surgery of cholesteatoma. I closed techniques [Spanish]. Acta Otolaryngol Esp 1997;48:115–20Google ScholarPubMed
12 Marald, O, Daculsi, G, Toquet, J, Beauvillain De Montreuil, C, Legent, F, Bordure, P. Autografts versus biomaterials for ossiculoplasty with normal stapes; a comparative analysis of functional outcome in 100 cases. Ann Otolaryngol Chir Cervicofac 2001;118:225–31Google Scholar
13 Murugasu, E, Puria, S, Robsons, JB Jr. Malleus to footplate versus malleus to stapes head ossicular reconstruction prosthesis: temporal bone pressure gain measurements and clinical audiological data. Otol Neurotol 2005;26:572–82CrossRefGoogle ScholarPubMed
14 Colletti, V, Fiorino, FC, Sittoni, V. Minisculptured ossicle grafts versus implants: long term results. Am J Otol 1987;8:553–9Google ScholarPubMed
15 Silverstein, H, McDaniel, AB, Lichtenstein, R. A comparison of PORP, TORP, and incus homograft for ossicular reconstruction: an update. Laryngoscope 1986;96:159–65CrossRefGoogle Scholar
16 Grote, JJ. Reconstruction of the ossicular chain with hydroxylapatite prosthesis. Am J Otology 1987;8:396–401Google Scholar
17 Nikolaou, A, Borikas, Z, Maltas, V, Aidonis, A. Ossiculoplasty with the use of autografts and synthetic prosthetic materials: a comparison of results in 165 cases. J Laryngol Otol 1992;106:692–4CrossRefGoogle ScholarPubMed
18 Duckert, LG, Muller, J, Makeilski, KH, Helms, J. Composite autograft “shield” reconstruction of remnant tympanic membranes. Am J Otol 1995;16:21–6Google ScholarPubMed
19 Dornhoffer, JL. Hearing results with cartilage tympanoplasty. Laryngoscope 1997;107:1094–9CrossRefGoogle ScholarPubMed
20 Spielmann, P, Mills, R. Surgical management of retraction pockets of the pars tensa with cartilage and perichondrial grafts. J Laryngol Otol 2006;120:725–9CrossRefGoogle ScholarPubMed
21 Shin, S-H, Lee, W-S, Kim, H-N, Lee, H-K. Wheel-shaped cartilage-perichondrium composite graft for the prevention of retraction pocket development. Acta Otolaryngol (Stockh) 2007;127:25–8CrossRefGoogle ScholarPubMed
22 Eavey, RD. Inlay tympanoplasty: cartilage butterfly technique. Laryngoscope 1998;108:657–61CrossRefGoogle ScholarPubMed
23 Hartwein, J, Leuwer, RM, Kehrl, W. The total reconstruction of the tympanic membrane by the “crown cork” technique. Am J Otolaryngol 1992;13:172–5CrossRefGoogle Scholar
24 Neumann, A, Jahnke, K. Tympanic membrane reconstruction using cartilage – indications, techniques and results [in German]. HNO 2005;53:573–84CrossRefGoogle ScholarPubMed
25 Ng, SK, Yip, WW, Suen, M, Abdullah, VJ, van Hasselt, CA. Autograft ossiculoplasty in cholesteatoma ears: is it really feasible? Laryngoscope 2003;113:843–7CrossRefGoogle ScholarPubMed
26 Zahnert, T, Huttenbrink, K-B, Murbe, D, Bornitz, M. Experimental investigations of the use of cartilage in the tympanic membrane reconstruction. Am J Otology 2000;21:322–8CrossRefGoogle ScholarPubMed
27 Murbe, D, Zahnert, T, Bornitz, M, Huttenbrink, KB. Acoustic properties of different cartilage reconstruction techniques of the tympanic membrane. Laryngoscope 2002;112:1769–76CrossRefGoogle ScholarPubMed