gms | German Medical Science

Objective: Evaluation of morphological and functional long term results of palisade cartilage tympanoplasty (PCT) Type I and in combination with titanium ossicular reconstruction prostheses in type III tympanoplasty.

Study design: Retrospective review of tympanoplasties.

Setting: Tertiary referral center.

Patients: 22 patients (8 women and 14 men, mean age 41 years, range 8 to 69 years) operated on more than 10 years ago (mean follow up 9,1 years) due to cholesteatoma, adhesive otitis, chronic otitis media, subtotal tympanic membrane defects and tympanofibrosis requiring tympanoplasty( 8 PCT type I, 14 PCT type III).

Interventions: Tympanoplasty, applying the PCT. When ossiculoplasty was applied, Total or Partial Titanium Ossicular Reconstruction Prostheses (TORP and PORP) were used.

Main Outcome Measures: Questionnaire on postoperative cours, otoscopic findings and hearing results using a four-frequency pure-tone average air-bone gap (PTA-ABG).

Results: A recurrent defect was not observed (0%). The graft take rate was 100%. There was one extrusion of prostheses which required revision surgery and insertion of a shorter prosthesis. In the PCT type I group, preoperatively a PTA-ABG of 0–10 dB was seen in 0 ear, 11–30 dB in 7 and 31–59 dB in another 1ear. Postoperatively the corresponding numbers were 4, 4 and 0 ears. In cases applying the PCT type III the corresponding preoperative PTA-ABG were seen in 1,6 and 5 ears. Postoperatively, 7 ears revealed a PTA-ABG of up to 10 dB. In another 4 ears the PTA-ABG was 10–30 dB whereas only one ear had a PTA-ABG of more than 30 dB.

Conclusions: The PCT is a reliable surgical method also on a long term (>9 years) base to manage difficult middle ear conditions. It offers satisfactory morphological and functional results performed either as a type I tympanoplasty or in combination with titanium prosthesis ossiculoplasty.