title: Myringoplasty for anterior and subtotal perforations using KTP-532 laser.
abstract: A retrospective study was performed on patients who underwent myringoplasty for either anterior or subtotal perforations over an 8-year period (from 1994 till 2004). We used the KTP-laser assisted anterior anchoring technique combining with anterior "pull-back" method. Patients' ages ranged from 6-62 years (median 36.5). The mean follow-up period was 2.8 years (minimum 6 months). The audiological results were analysed with the "Pytel software", which was developed in our department. As for the procedure, the drum remnant was freed from the malleus handle with the use of the laser and elevated out of it's sulcus anterior-superiorly. Large fascia graft was fashioned with a split of 4-5 mm in the middle of one edge. The graft was placed using the underlay technique medial to the handle of the malleus. A pull-back tunnel was created at the border of the anterior quadrants to further facilitate the survival of the graft. In this series the graft taking rate was 100%. Reperforation due to an undersized fascia was observed in one case. Post-operative audiological results indicated no bone conduction threshold elevation in any frequencies. Using the laser, cochlear trauma can be prevented, double fixation of the drum prevents lateralisation and blunting. Wide canalplasty makes both the approach and the follow-up very easy. Thorough soft tissue and bone work is advantageous from the fascia taking rate point of view.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Medical School, University of Pécs, Munkácsy M. utca 2, 7621 Pécs, Hungary. gerlingerimre@hotmail.com
authors.forename: Imre
authors.initials: I
authors.lastname: Gerlinger
authors.forename: Gábor
authors.initials: G
authors.lastname: Ráth
authors.forename: István
authors.initials: I
authors.lastname: Szanyi
authors.forename: József
authors.initials: J
authors.lastname: Pytel
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009225:Myringoplasty / Q000379:methods*; D012189:Retrospective Studies; D014432:Tympanic Membrane / Q000601:surgery*; D018058:Tympanic Membrane Perforation / Q000601:surgery*