title: Cartilage tympanoplasty in smokers.
abstract: OBJECTIVE
  We compared the outcomes of cartilage tympanoplasty in nonsmokers and smokers.
  
  
  METHODS
  We performed a retrospective chart review of patients who underwent cartilage tympanoplasty in a tertiary academic medical center from 1991 to 2010. There were 129 operations in 118 patients; 84 operations were performed in nonsmokers and 45 operations were performed in smokers. The primary outcome measure was the tympanic membrane graft take rate at the interval and most recent follow-up visits. Secondary measures included recurrence, the need for revision surgery, and hearing outcomes.
  
  
  RESULTS
  Nonsmokers and smokers had comparable long-term rates of intact eardrums (90.6% versus 92.9%; p = 0.99). There was a trend toward a higher rate of recurrent or persistent disease requiring further operation for smokers (13.3% versus 4.7%; p = 0.09). Both groups had improvement in pure tone averages (12.1 dB in nonsmokers and 12.8 dB in smokers) and air-bone gaps (9.6 dB in nonsmokers and 5.1 dB in smokers), although the rates were not statistically significantly different from each other. The rates of success of cartilage tympanoplasty in smokers appear superior to previously published rates of noncartilage tympanoplasty.
  
  
  CONCLUSIONS
  Cartilage tympanoplasty has success rates and postoperative audiological measures that are comparable between smokers and nonsmokers. In smokers, cartilage grafting is superior to noncartilage grafting and is recommended for any patient who smokes and is undergoing tympanoplasty.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia 23298-0146, USA. dcoelho@mcvh-vcu.edu
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Coelho
authors.forename: Angela
authors.initials: A
authors.lastname: Peng
authors.forename: Meghan
authors.initials: M
authors.lastname: Thompson
authors.forename: Aristides
authors.initials: A
authors.lastname: Sismanis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001844:Bone Conduction; D002356:Cartilage / Q000637:transplantation*; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012907:Smoking; D016896:Treatment Outcome; D014433:Tympanoplasty; D055815:Young Adult