2015 Volume 25 Issue 3 Pages 239-244
Cartilage has been popular for treating tympanoplasty in Europe, particularly in Germany. However, use of this material has been uncommon among Japanese surgeons. In our department, 41 cases with adhesive otitis media were treated using palisade cartilage tympanoplasty between 2006 and 2011, and 48 cases were treated by tympanoplasty using one plate of thinly sliced cartilage between 2009 and 2012. In this study, we compared surgical results between these techniques. Postoperative hearing success rate was 61% in the palisade group and 67% in the thinly sliced group, according to the 2010 criteria of the Japan Otology Society. In the palisade group, postoperative air-bone gap was 11–20 dB in 18 cases (50%), 21–30 dB in 12 cases (33%), and >30 dB in 6 cases (17%). In the thinly sliced cartilage group, postoperative air-bone gap was 10 dB in 8 cases (18%), 11–20 dB in 14 cases (32%), 21–30 dB was in 16 cases (37%), and >30 dB in 5 cases (12%). These rates did not significantly differ between the two techniques. Successful hearing results were obtained in 6 cases (86%) of type I, 10 cases (59%) of modified type III, and 6 cases (50%) modified type IV in the palisade group. In the thinly sliced cartilage group, successful hearing results were obtained in 6 cases (67%) of type I, 12 cases (60%) of modified type III, and 11 cases (79%) of modified type IV. Hearing improvement after surgery was not related to the ossicular reconstruction. Total number of reoperations during follow-up was 1 case (4%) for the palisade group and 4 cases (11%) for thinly sliced cartilage group (Kaplan-Meier method). This rate did not differ significantly between techniques. These results suggest that cartilage tympanoplasty for adhesive otitis media is superior to other surgical techniques despite the different surgical procedure.
