Palisade Cartilage Tympanoplasty, an Alternative Surgical Approach for CSOM

Introduction:The hearing outcome and graft take in patients of CSOM with sclerotic mastoids were studied using the novel technique of palisade cartilage tympanoplasty. Besides, it was compared with tympanoplasty type-۱ above and over the cortical mastoidectomy in both groups. Materials and Methods:Out of ۳۱۳ patients of CSOM, ۱۲۵ had sclerotic mastoid and were included in the study. Palisade cartilage group patients were subjected to palisade cartilage tympanoplasty type-۱. While as in the Temporalis fascia group patients, type-۱ tympanoplasty was done using temporalis fascia as graft material. These procedures were performed in addition to cortical mastoidectomy done in all cases. Results:Statistically significant (P<۰.۰۰۱) mean postoperative hearing gain was achieved (> ۲۰ dB) in both the groups with a reduction of AB gap to ۱۳.۳ & ۱۱.۷۹ dB, respectively. However, the post-surgery hearing outcomes achieved were similar in both groups (P=۰.۰۹). The overall graft take rate of ۸۶% was seen in the Palisade cartilage group. The remaining ۱۴% had graft take failure. The primary graft failure rate was ۱۰% (۵/۵۰), and the secondary failure rate within six months of follow-up was ۴% (۲/۵۰). The Temporalis fascia group graft take rate was higher (۹۲%) than the Palisade cartilage group, with only ۴ % (۳/۷۵) of cases having a primary graft failure rate. However, these findings (۹۲% vs. ۸۶%) were not statistically significant (P=۰.۲۸۳۰). Conclusions:As the hearing outcomes and graft take rates were comparable in the two groups, the present study highlighted the use of palisade cartilage tympanoplasty in patients of CSOM with sclerotic mastoids as an alternative method to tympanoplasty. 

Keywords:

Cartilage tympanoplasty , Sclerotic Mastoids , Myringoplasty , Type ۱ Tympanoplasty