Torun Mümtaz Taner
Department of Ear Nose and Throat Diseases, Bandırma Onyedi Eylül University Faculty of Medicine Yeni Mahalle, Şehit Astsubay, Mustafa Soner Varlık Street Number:75, Bandırma/Balıkesir, 10200 Turkey.
Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5293-5298. doi: 10.1007/s12070-024-04965-5. Epub 2024 Aug 24.
Cartilage perichondrium composite grafts (CPCG) have been used in tympanoplasty for many years. Reperforations can be seen because of various problems. The aim of our study is to describe a graft technique to minimise the complications and to evaluate the success of the graft. The ears which underwent type 1 tympanoplasty using CPCG were included in the study. Over-underlay graft technique was used in all operations. They were performed by microscopic transcanal approach and by the same surgeon. Fifty-four ear operations of 48 patients were included in the study. While the preoperative average pure tone- average (PTA) of the ears was 45 (21-75) dB, the postoperative average PTA was 28 (11-58) dB. While the preoperative air bone gap (ABG) of the ears was 23.3 (10-43.3) dB, the postoperative ABG was 11.6 (0-28.3) dB. A significant improvement was achieved in both ABG and PTA values after the operation ( < 0.001). The graft success rate was 94.4%. The cartilage graft modifications such as block cartilage, palisade, cartilage island and butterfly have been applied successfully. We aimed to reduce the risk of reperforation, maximise audiological gain and facilitate the follow-up of postoperative middle ear pathologies by thinning the cartilage island and extending the perichondrium to the external auditory canal in the modification of CPCG. The graft success rate and the audiological success rate are high enough to be compared with the literature. The described CPCG can be used safely in all types of perforations, especially in high-risk perforations.
The online version contains supplementary material available at 10.1007/s12070-024-04965-5.
软骨-软骨膜复合移植物（CPCG）已用于鼓室成形术多年。由于各种问题可能会出现再穿孔。我们研究的目的是描述一种移植物技术以尽量减少并发症并评估移植物的成功率。本研究纳入了采用CPCG进行Ⅰ型鼓室成形术的耳朵。所有手术均采用上-下置法移植物技术。手术通过显微镜下经耳道入路且由同一位外科医生进行。本研究纳入了48例患者的54耳手术。术前耳朵的平均纯音平均听阈（PTA）为45（21 - 75）dB，术后平均PTA为28（11 - 58）dB。术前耳朵的气骨导差（ABG）为23.3（10 - 43.3）dB，术后ABG为11.6（0 - 28.3）dB。术后ABG和PTA值均有显著改善（<0.001）。移植物成功率为94.4%。已成功应用了如块状软骨、栅栏状、软骨岛和蝶形等软骨移植物改良方法。在CPCG改良中，我们旨在通过减薄软骨岛并将软骨膜延伸至外耳道来降低再穿孔风险、最大化听力学增益并便于术后中耳病变的随访。移植物成功率和听力学成功率足够高，可与文献进行比较。所描述的CPCG可安全用于所有类型的穿孔，尤其是高风险穿孔。
在线版本包含可在10.1007/s12070 - 024 - 04965 - 5获取的补充材料。
