Long-term results of palisade cartilage tympanoplasty.

OBJECTIVE

Evaluation of morphologic and functional long-term results of palisade cartilage tympanoplasty (PCT) combined with titanium ossicular replacement prostheses.

STUDY DESIGN

Retrospective review of tympanoplasties.

SETTING

Tertiary referral center.

PATIENTS

Twenty-nine patients (12 women and 17 men; mean age, 39 yr; range, 17-72 yr) operated on more than 9 years ago (mean follow up, 9.1 yr) because of cholesteatoma, adhesive otitis, chronic otitis media, subtotal tympanic membrane defects, and tympanic fibrosis requiring tympanoplasty.

INTERVENTIONS

Tympanoplasty, applying the PCT. For ossiculoplasty, total or partial titanium ossicular replacement prostheses were used.

MAIN OUTCOME MEASURES

Questionnaire on postoperative course, otoscopic findings, and hearing results using a 4-frequency pure-tone average air-bone gap.

RESULTS

A recurrent defect was not observed. The graft take rate was 100%. There was one case of prosthesis protrusion which required revision surgery and insertion of a shorter prosthesis. A pure-tone average air-bone gap of 0 to 10 dB was seen preoperatively in 1 ear, 11 to 30 dB in 16 ears, and 31 to 59 dB in 12 ears. Postoperatively, the corresponding numbers were 10, 15, and 4 ears.

CONCLUSION

The PCT is a reliable surgical method to manage difficult middle ear pathology on a long-term (>9 yr) basis. It offers satisfactory morphologic and functional results in combination with titanium prosthesis ossiculoplasty.