Karaman Emin, Duman Cihan, Isildak Huseyin, Enver Ozgun
Department of Otorhinolaryngology, Cerrahpasa Medicine Faculty, Istanbul University, Istanbul, Turkey.
J Craniofac Surg. 2010 Jan;21(1):37-9. doi: 10.1097/SCS.0b013e3181c36283.
Tympanoplasty is a surgical procedure used for eradicating chronic middle ear infection and for reconstructing hearing in infected ears. Independent from the graft placing technique, the atrophy and the insufficiency of the graft material would be seen.For cases at high risk for failure, such as recurrent perforations, total perforations, and severely atelectatic tympanic membranes, many surgeons have used cartilage as a grafting material because of its increased stability and resistance to negative middle ear pressure. Various cartilage grafting techniques have been described, including the palisade, cartilage island, and cartilage shield.In our study, we investigated audiological and otological outcomes of tympanoplasty type 1 with composite cartilage island grafts. Between 2004 and 2008, 100 cases of composite cartilage island tympanoplasty were identified. A total of 74 patients were attended to in this study. Graft take was evaluated in all patients, and postoperative complications were noted. Hearing results were analyzed by comparing the preoperative and postoperative pure-tone average air-bone gap. Graft take was accomplished in 72 patients (97.29%). There was no graft lateralization or displacement in the middle ear. The mean postoperative pure-tone average air-bone gap improvement was 20.2 dB at 500 Hz, 23.58 dB at 1000 Hz, 22.23 dB at 2000 Hz, and 24.79 at 4000 Hz.Our study indicates that composite cartilage island tympanoplasty has a high degree of reliability and excellent hearing improvement especially in patients at high risk for graft failure.
鼓室成形术是一种用于根除慢性中耳感染和重建感染耳听力的外科手术。无论采用何种移植物植入技术，都可能出现移植物萎缩和不足的情况。对于失败风险较高的病例，如复发性穿孔、完全穿孔和严重萎缩性鼓膜，许多外科医生使用软骨作为移植材料，因为其稳定性更高且能抵抗中耳负压。已经描述了多种软骨移植技术，包括栅栏状、软骨岛状和软骨盾状。在我们的研究中，我们调查了采用复合软骨岛移植物的Ⅰ型鼓室成形术的听力学和耳科学结果。2004年至2008年期间，共确定了100例复合软骨岛鼓室成形术病例。本研究共纳入74例患者。评估了所有患者的移植物成活情况，并记录了术后并发症。通过比较术前和术后纯音平均气骨导差来分析听力结果。72例患者（97.29%）移植物成活。中耳内未出现移植物侧方移位或移位情况。术后500Hz时纯音平均气骨导差平均改善20.2dB，1000Hz时为23.58dB，2000Hz时为22.23dB，4000Hz时为24.79dB。我们的研究表明，复合软骨岛鼓室成形术具有高度的可靠性，尤其在移植物失败风险较高的患者中能显著改善听力。
