title: Type III cartilage "shield" tympanoplasty: an effective procedure for hearing improvement.
abstract: OBJECTIVE
  To report the hearing results following type III cartilage "shield" tympanoplasty.
  
  
  METHODS
  Retrospective chart review at a tertiary referral center.
  
  
  METHODS
  Conchal cartilage, shaped as a shield, was used to replace the entire tympanic membrane and reconstruct the ossicular chain in patients with an absent incus and diminished space between the stapes superstructure and malleolar manubrium.
  
  
  RESULTS
  Between January 1998 and June 2005, 52 patients were treated. The mean age was 32.4 years (range, 7 to 72 years). The mean follow-up was 24 months (range, 12 to 36 months). Graft take was successful in all patients. The average hearing improvement was 11.22 dB (P<0.0001). An air-bone gap of 25 dB or less was achieved in 41 (78.8%) patients. Speech discrimination scores remained unchanged. No complications were identified.
  
  
  CONCLUSIONS
  Type III cartilage "shield" tympanoplasty is an effective technique for hearing improvement in selected patients with chronic otitis media. The results of this procedure are similar to those obtained with partial ossicular replacement prosthesis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
authors.forename: Efthymios
authors.initials: E
authors.lastname: Kyrodimos
authors.forename: Aristides
authors.initials: A
authors.lastname: Sismanis
authors.forename: Daniel
authors.initials: D
authors.lastname: Santos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D002908:Chronic Disease; D004429:Ear Ossicles / Q000601:surgery; D005260:Female; D006314:Hearing Loss, Conductive / Q000601:surgery*; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D009998:Ossicular Prosthesis; D010033:Otitis Media / Q000601:surgery*; D013063:Speech Discrimination Tests; D014433:Tympanoplasty / Q000379:methods*