Cartilage plate tympanoplasty.
OBJECTIVE
The purpose of this work was to report our modified cartilage plate tympanoplasty technique ("tulip leaves") and to analyze its clinical outcome in primary and recurrent cases of chronic otitis media with and without cholesteatoma.


METHODS
Clinical retrospective study.


METHODS
Patients being operated on with this technique at the University Department of Otorhinolaryngology, Dresden, Germany, between 1993 and 2001 were invited for survey, otomicroscopy, and pure-tone audiometry in 2003. Patients' charts were used to draw necessary conclusions.


RESULTS
A total of 39 patients who were treated with this technique after canal wall down tympanomastoidectomy and cavity obliteration were included in this long-term analysis after a median follow-up of 6 years. Seventeen patients (44%) experienced chronic otitis media with cholesteatoma, whereas 22 (56%) of them had a diagnosis of chronic otitis media without cholesteatoma. At the time of examination, all patients displayed a closed tympanic membrane. However, retractions were observed in 19 patients (48%). One patient required (3%) revision surgery for recurrent cholesteatoma due to prosthesis extrusion during the study period.


CONCLUSIONS
On the basis of this study, we recommend the tuliplike arrangement of thin but large auricular cartilage slices for the reconstruction of tympanic membrane defects in high-risk ears. This combination proved its high stability and long-lasting vitality in our long-term study. These characteristics are crucial for permanent disease removal and for reducing the risk of recurrent pathologic abnormality.
Beutner
Dirk
D
Department of Otorhinolaryngology/Head and Neck Surgery, University of Cologne, Cologne, Germany. dirk.beutner@uni-koeln.de
Huttenbrink
Karl-Bernd
KB
Stumpf
Robert
R
Beleites
Thomas
T
Zahnert
Thomas
T
Luers
Jan-Christoffer
JC
Helmstaedter
Victor
V
D000328:Adult; D001301:Audiometry, Pure-Tone; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010033:Otitis Media / Q000601:surgery*; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*; D014433:Tympanoplasty / Q000379:methods*