title: 'Umbrella' graft tympanoplasty.
abstract: OBJECTIVE
  Tympanoplasty continues to pose a challenge in developing countries, where treatment cost and lack of compliance with second stage surgery are often important factors in determining the surgical strategy. This study aimed to determine the effectiveness of the newly developed, 'umbrella' autograft.
  
  
  METHODS
  In 22 patients suffering chronic suppurative otitis media, in whom the incus and stapes suprastructure were found to be absent during surgery, reconstruction was achieved using cartilage-malleus umbrella graft assembly. Six-month post-operative results were evaluated on the basis of average hearing gain, measured at 0.5, 1, 2 and 3 kHz.
  
  
  RESULTS
  At six months post-operatively, 77.3 per cent of patients showed hearing improvement. Audiography at this time indicated significant improvement (p < 0.001), suggesting that this hearing gain may stand the test of time.
  
  
  CONCLUSIONS
  Umbrella graft tympanoplasty appears to be a promising technique in terms of cost-effectiveness and the autologous nature of implant materials.
authors.affiliation: Department of Otorhinolaryngology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India. manumalhotrallrm@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Malhotra
mesh_terms: D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000601:surgery / Q000637:transplantation*; D002908:Chronic Disease; D005260:Female; D006309:Hearing / Q000502:physiology; D006801:Humans; D008297:Male; D008307:Malleus / Q000601:surgery*; D008875:Middle Aged; D010035:Otitis Media, Suppurative / Q000601:surgery*; D013201:Stapes Surgery / Q000379:methods*; D014433:Tympanoplasty / Q000379:methods*; D055815:Young Adult