Lateral graft type 1 tympanoplasty using AlloDerm for tympanic membrane reconstruction in children.
OBJECTIVE
To describe the lateral graft type 1 tympanoplasty technique using AlloDerm for tympanic membrane reconstruction in children and to compare its surgical and audiometric outcomes with the traditional underlay type 1 tympanoplasty.


METHODS
The records of 34 consecutive children undergoing type 1 tympanoplasty between 2004 and 2005 were reviewed; 18 received lateral graft tympanoplasty with AlloDerm and 16 received underlay tympanoplasty (8 AlloDerm and 8 temporalis fascia). Pre- and post-surgical audiograms, speech reception threshold, closure rate and complication rate were evaluated using one-way and repeated measures ANOVAs.


RESULTS
Children who underwent lateral graft type 1 tympanoplasty pre-operatively had larger tympanic membrane perforations, worse pure tone averages, air bone gaps and speech reception thresholds as compared with children undergoing underlay type 1 tympanoplasty (P<0.001). Pure tone averages and air bone gaps improved significantly with surgery in both lateral and underlay type 1 tympanoplasty groups (P<0.05), with both groups achieving comparable postoperative audiometric outcomes (P>0.01). The lateral graft group demonstrated a higher perforation closure rate (94%) as compared with both underlay groups (88%). Complication rates were virtually non-existent.


CONCLUSIONS
Despite larger perforations and worse pre-operative audiometric scores, children who underwent lateral graft type 1 tympanoplasty achieved comparable postoperative audiometric results and perforation closure rates as compared with children who underwent underlay type 1 tympanoplasty. Results suggest that lateral graft type 1 tympanoplasty using AlloDerm is effective for tympanic membrane reconstruction in children and should be used when temporalis fascia is not available or the extent of the perforation limits its use.
Lai
Philip
P
Department of Otolaryngology--Head and Neck Surgery, The Hospital for Sick Children, Toronto, Ont., Canada.
Propst
Evan Jon
EJ
Papsin
Blake Croll
BC
D000293:Adolescent; D001299:Audiometry; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001844:Bone Conduction; D002648:Child; D003094:Collagen / Q000627:therapeutic use*; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D017768:Skin, Artificial; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000601:surgery*
C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen