title: Cartilage "shield" grafts in revision tympanoplasty.
abstract: OBJECTIVE
  To report our experience with cartilage "shield" grafts in revision tympanoplasty.
  
  
  METHODS
  Retrospective chart review at a tertiary referral center. Patients underwent revision tympanoplasties by replacing the entire tympanic membrane with concha cymba cartilage shaped as a shield.
  
  
  METHODS
  Successful graft take was defined as having no perforation, graft retraction, or lateralization. Hearing results were analyzed by comparing the preoperative and postoperative pure-tone average air-bone gap and speech discrimination scores.
  
  
  RESULTS
  Forty-three patients underwent 46 procedures. Graft take was successful in 43 procedures (93.5%). There was no graft lateralization or displacement into the middle ear. An overall postoperative air-bone gap of 25 dB or less was achieved in 22 of the 39 patients (56.4%), and speech discrimination scores remained unchanged.
  
  
  CONCLUSIONS
  Cartilage shield tympanoplasty is a reliable procedure for revision tympanoplasty patients, with excellent graft take and significant improvement of hearing.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA. asismanis@mcvn-vcu.edu
authors.forename: Aristides
authors.initials: A
authors.lastname: Sismanis
authors.forename: Kelley
authors.initials: K
authors.lastname: Dodson
authors.forename: Efthymios
authors.initials: E
authors.lastname: Kyrodimos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D006085:Graft Survival; D006309:Hearing; D006801:Humans; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D009998:Ossicular Prosthesis; D011183:Postoperative Complications; D011312:Pressure; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*