title: Revision Myringoplasty Using Thin-Sliced Cartilage for Postoperative Reperforation in Patients with Chronic Otitis Media.
abstract: Myringoplasty is one of the basic procedures in otologic surgery, and is important to achieve good hearing outcome. The temporal fascia is most widely used and considered to be a stable graft in this procedure, although 10-20% of patients develop reperforation after surgery, which is often hard to repair, even by revision surgery. We herein conducted revision myringoplasty using a cartilage graft to repair postoperative reperforation in 7 patients (8 ears) with chronic otitis media. The patients were 3 males and 4 females, aged 13-80 years with an average of 53.9 years. A cartilage graft was harvested from the tragus, sliced in 0.3 mm thickness with perichondrium attached on one side, and trimmed into an appropriate shape and size. The graft was then underlaid beneath the perforation and fixed with fibrin glue. The operation was Wullstein type I tympanoplasty in 5 ears and myringoplasty in 3 ears, using the temporal fascia in 7 ears and subcutaneous tissue in 1 ear. The postoperative follow-up period ranged from 16 to 44 months with an average of 30.0 months. Perforation of the tympanic membrane was successfully closed in 7 ears (87.5%). Hearing outcome was judged successful in 5 ears (62.5%) according to the criteria of the Otological Society of Japan (postoperative hearing level < 30 dB, hearing gain > 15 dB, or postoperative air-bone gap < 15 dB). These results indicate that cartilage is a stable and reliable graft material for revision myringoplasty to repair postoperative reperforation in patients with chronic otitis media.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Koizumi
authors.forename: Takuro
authors.initials: T
authors.lastname: Kitamura
authors.forename: Takahisa
authors.initials: T
authors.lastname: Tabata
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kise
authors.forename: Koichi
authors.initials: K
authors.lastname: Hashida
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002356:Cartilage / Q000637:transplantation*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009225:Myringoplasty; D010033:Otitis Media / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012008:Recurrence; D018058:Tympanic Membrane Perforation / Q000601:surgery*; D055815:Young Adult