Wielgosz Romuald, Mroczkowski Edward
Klinika Otolaryngologiczna Szpitala A. Kruppa w Essen, Niemcy.
Otolaryngol Pol. 2006;60(6):901-5.
The cartilage has been successfuly used in reconstructive ear surgery for more than one hundred years. Histologic study of autografts cartilage (tragal or conchal) showed good long-term preservation of cartilage cells. The aim of this paper is to assess the hearing results in tympanoplasties with the use of cartilage palisade technique.
The retrospective analysis concerned 108 operated clinical cases. The cartilage palisade technique was performed in 28 tympanoplasties type I, 47 tympanoplasties type II, 21 tympanoplasties type III with columella and in 2 tympanoplasties type IV. Clinical assessment included otoscopy, test for eustachian tube ventilation, test with tuning fork, audiometry on a range 0,5, 1, 2 kHz and subjective evaluation based on questionaire.
The Air Bone Gap (ABG) was noted as follows: < 10 dB among 67,8% of patients and 11-20 dB among 21,4% of patients in tympanoplasty type I. In tympanoplasty type II the ABG was responsively: < 10 dB - 80% patients, 11-20 dB - 10% patients. In the type III of tympanoplasty 40,4% of patients showed ABG < 10 dB and 42,5% of patients 11-20 dB. In the type III with columella we noted 15% patients with ABG < 10 dB and 65% of them with ABG 11-20 dB.
The cartilage is a good autograft for reconstruction of the tympanic membrane, middle ear and the auditory wall because of stability and lack of secondary perforations. Long-term results in hearing are also satisfactory.
软骨已成功应用于耳再造手术一百多年。自体软骨（耳屏或耳甲）的组织学研究显示软骨细胞长期保存良好。本文旨在评估使用软骨栅栏技术进行鼓室成形术的听力结果。
回顾性分析了108例手术临床病例。在28例I型鼓室成形术、47例II型鼓室成形术、21例带小柱的III型鼓室成形术和2例IV型鼓室成形术中采用了软骨栅栏技术。临床评估包括耳镜检查、咽鼓管通气试验、音叉试验、0.5、1、2kHz范围内的听力测定以及基于问卷的主观评估。
I型鼓室成形术中，67.8%的患者气骨导间距（ABG）<10dB，21.4%的患者ABG为11 - 20dB。II型鼓室成形术中，相应地，ABG<10dB的患者占80%，11 - 20dB的患者占10%。III型鼓室成形术中，40.4%的患者ABG<10dB，42.5%的患者ABG为11 - 20dB。在带小柱的III型鼓室成形术中，我们注意到15%的患者ABG<10dB，65%的患者ABG为11 - 20dB。
由于稳定性和无继发性穿孔，软骨是鼓膜、中耳和听壁重建的良好自体移植材料。听力的长期结果也令人满意。
