Rasool Shahid, Qureshi Shifa, Varshney Ashima, Hassan Simmi, Kokab Faiza, Naseeruddin Khaja
Department of Otorhinolaryngology Head and Neck Surgery, Hamdard Institute of Medical Sciences, New Delhi, India.
Iran J Otorhinolaryngol. 2022 Jul;34(123):179-183. doi: 10.22038/IJORL.2022.60937.3093.
The hearing outcome and graft take in patients of CSOM with sclerotic mastoids were studied using the novel technique of palisade cartilage tympanoplasty. Besides, it was compared with tympanoplasty type-1 above and over the cortical mastoidectomy in both groups.
Out of 313 patients of CSOM, 125 had sclerotic mastoid and were included in the study. Palisade cartilage group patients were subjected to palisade cartilage tympanoplasty type-1. While as in the Temporalis fascia group patients, type-1 tympanoplasty was done using temporalis fascia as graft material. These procedures were performed in addition to cortical mastoidectomy done in all cases.
Statistically significant (P<0.001) mean postoperative hearing gain was achieved (> 20 dB) in both the groups with a reduction of AB gap to 13.3 & 11.79 dB, respectively. However, the post-surgery hearing outcomes achieved were similar in both groups (P=0.09). The overall graft take rate of 86% was seen in the Palisade cartilage group. The remaining 14% had graft take failure. The primary graft failure rate was 10% (5/50), and the secondary failure rate within six months of follow-up was 4% (2/50). The Temporalis fascia group graft take rate was higher (92%) than the Palisade cartilage group, with only 4 % (3/75) of cases having a primary graft failure rate. However, these findings (92% vs. 86%) were not statistically significant (P=0.2830).
As the hearing outcomes and graft take rates were comparable in the two groups, the present study highlighted the use of palisade cartilage tympanoplasty in patients of CSOM with sclerotic mastoids as an alternative method to tympanoplasty.
采用新型栅栏状软骨鼓室成形术，对中耳胆脂瘤合并硬化型乳突患者的听力结果及移植物存活情况进行了研究。此外，将其与上述两组患者在皮质乳突切除术后的Ⅰ型鼓室成形术进行了比较。
在313例中耳胆脂瘤患者中，125例有硬化型乳突，被纳入本研究。栅栏状软骨组患者接受Ⅰ型栅栏状软骨鼓室成形术。而颞肌筋膜组患者则使用颞肌筋膜作为移植物材料进行Ⅰ型鼓室成形术。所有病例均在皮质乳突切除术的基础上进行这些手术。
两组术后平均听力增益均具有统计学意义（P<0.001）（>20dB），气骨导差分别降至13.3dB和11.79dB。然而，两组术后听力结果相似（P=0.09）。栅栏状软骨组的总体移植物存活率为86%。其余14%移植物存活失败。原发性移植物失败率为10%（5/50），随访6个月内的继发性失败率为4%（2/50）。颞肌筋膜组的移植物存活率（92%）高于栅栏状软骨组，原发性移植物失败率仅为4%（3/75）。然而，这些结果（92%对86%）无统计学意义（P=0.2830）。
由于两组的听力结果和移植物存活率相当，本研究强调了在中耳胆脂瘤合并硬化型乳突患者中使用栅栏状软骨鼓室成形术作为鼓室成形术的替代方法。
