Hostname: page-component-5b777bbd6c-rbv74 Total loading time: 0 Render date: 2025-06-18T16:33:20.851Z Has data issue: false hasContentIssue false
  • English
  • Français

The split two-layer cartilage–perichondrium underlay technique for tympanoplasty: surgical and functional outcome in 108 adult patients

Published online by Cambridge University Press:  30 April 2024

Charikleia Maiou ,
Allanah McMinigal  and
Georgios Kontorinis Open the ORCID record for Georgios Kontorinis [Opens in a new window]
Charikleia Maiou
Affiliation:
Department of Otolaryngology–Head & Neck Surgery, Queen Elizabeth University Hospital, Glasgow, UK
Allanah McMinigal
Affiliation:
Medical School, University of Glasgow, UK
Georgios Kontorinis*
Affiliation:
Department of Otolaryngology–Head & Neck Surgery, Queen Elizabeth University Hospital, Glasgow, UK Medical School, University of Glasgow, UK
*
Corresponding author: Georgios Kontorinis; Email: gkontorinis@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

The success of tympanoplasty is mainly defined by the post-operative integrity of the tympanic membrane, as well as the absence of any need for further operating. Among the factors affecting the outcome, the surgical grafting technique is still a matter of debate. Our aim is to report the results of the split two-layer cartilage–perichondrium technique.

Methods

We carried out a retrospective study of 108 consecutive adult patients undergoing myringoplasty, assessing both surgical and audiological outcomes of the split two-layer cartilage–perichondrium technique, including primary and revision cases.

Results

Complete perforation closure was observed in 97/108 (89.7 per cent) of the cases; 101/108 (93.5 per cent) had no need for further intervention. Failures were observed only in cases with total perforations without any differences between primary and revision cases. The average air–bone gap improved from 29.75 dB pre-operatively to 5.8 dB post-operatively.

Conclusion

The results indicate high success rates of the technique with failures occurring only in total perforations.

Keywords

conductive hearing lossmyringoplastytympanoplastytympanic membrane perforationossicular prosthesis
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 3 , March 2025 , pp. 203 - 207
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Georgios Kontorinis takes responsibility for the integrity of the content of the paper

References

Telian, SA, Schmalbach, CE. Chronic otitis media. In: Snow, JB, Ballenger, JJ, eds. Ballenger's Otorhinolaryngology: Head and Neck Surgery, 16th edn. Hamilton, Ontario: BC Decker; 2003:261–93Google Scholar
Adunka, OF, Buchman, CA. Surgery for chronic otitis media. In: Adunka, OF, Buchman, CA. Otology, Neurotology, and Lateral Skull Base Surgery: An Illustrated Handbook. New York, Thieme, 2011 10.1055/b-002-85469CrossRefGoogle Scholar
Salviz, M, Bayram, O, Bayram, AA, Balikci, HH, Chatzi, T, Paltura, C et al. Prognostic factors in type I tympanoplasty. Auris Nasus Larynx 2015;42:20–310.1016/j.anl.2014.08.010CrossRefGoogle ScholarPubMed
Jalali, MM, Motasaddi, M, Kouhi, A, Dabiri, S, Soleimani, R. Comparison of cartilage with temporalis fascia tympanoplasty: a meta-analysis of comparative studies. Laryngoscope 2017;127:2139–48CrossRefGoogle ScholarPubMed
Bayram, A, Bayar Muluk, N, Cingi, C, Bafaqeeh, SA. Success rates for various graft materials in tympanoplasty – a review. J Otol 2020;15:107–1110.1016/j.joto.2020.01.001CrossRefGoogle ScholarPubMed
Tos, M. Cartilage tympanoplasty methods: proposal of a classification. Otolaryngol Head Neck Surg 2008;139:747–5810.1016/j.otohns.2008.09.021CrossRefGoogle ScholarPubMed
Yung, M, Vivekanandan, S, Smith, P. Randomized study comparing fascia and cartilage grafts in myringoplasty. Ann Otol Rhinol Laryngol 2011;120:535–4110.1177/000348941112000808CrossRefGoogle ScholarPubMed
Demirpehlivan, IA, Onal, K, Arslanoglu, S, Songu, M, Ciger, E, Can, N. Comparison of different tympanic membrane reconstruction techniques in type I tympanoplasty. Eur Arch Otorhinolaryngol 2011;268:471–410.1007/s00405-010-1473-yCrossRefGoogle ScholarPubMed
Bedri, EH, Korra, B, Redleaf, M, Worku, A. Double-layer tympanic membrane graft in type I tympanoplasty. Ann Otol Rhinol Laryngol 2019;128:795–80110.1177/0003489419843551CrossRefGoogle ScholarPubMed
Jung, TTK, Park, SK. Mediolateral graft tympanoplasty for anterior or subtotal tympanic membrane perforation. Otolaryngol Head Neck Surg 2005;132:532–610.1016/j.otohns.2004.10.018CrossRefGoogle ScholarPubMed
Ismi, O, Gorur, K, Gur, H, Ozcan, C, Vayisoglu, Y. Double-layered (cartilage island + extra perichondrium) graft for type 1 tympanoplasty. Otolaryngol Head Neck Surg 2020;163:806–1310.1177/0194599820931400CrossRefGoogle ScholarPubMed
Andersen, SAW, Aabenhus, K, Glad, H, Sørensen, MS. Graft take-rates after tympanoplasty: results from a prospective ear surgery database. Otol Neurotol 2014;35:e292–710.1097/MAO.0000000000000537CrossRefGoogle ScholarPubMed
Lou, Z, Lou, Z, Wang, J, Zhang, B, Hu, Y, Chen, Z. Comparison of cartilage reinforcement and push-through techniques for the treatment of large perforations. Ear Nose Throat J 2023:145561323118266110.1177/01455613231182661CrossRefGoogle ScholarPubMed
Castelhano, L, Correia, F, Colaço, T, Reis, L, Escada, P. Tympanic membrane perforations: the importance of etiology, size and location. Eur Arch Otorhinolaryngol 2022;279:4325–3310.1007/s00405-021-07186-6CrossRefGoogle ScholarPubMed
Vaidya, S, Sharma, JK, Singh, G. Study of outcome of tympanoplasties in relation to size and site of tympanic membrane perforation. Indian J Otolaryngol Head Neck Surg 2014;66:341–610.1007/s12070-014-0733-3CrossRefGoogle ScholarPubMed