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Cartilage tympanoplasty: literature review

Published online by Cambridge University Press:  08 March 2017

M Yung
M Yung*
Affiliation:
Department of Otolaryngology, The Ipswich Hospital NHS Trust, UK
*
Address for correspondence: Mr Matthew Yung, Department of Otolaryngology, The Ipswich Hospital NHS Trust, Heath Road, Ipswich IP5 4PD, UK. Fax: 01473 793576, E-mail: [email protected]
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Abstract

There has been renewed interest in the use of cartilage for middle-ear reconstructions. The aim of the present review is to examine the indications, techniques and surgical outcomes of cartilage tympanoplasties reported in the literature. There have been concerns regarding weakening of cartilage struts, from histological studies involving explants; as a result, cartilage struts for ossiculoplasty have not gained popularity. On the other hand, cartilage tympanoplasty is now an established procedure for tympanic membrane and attic reconstruction. The commonest techniques involve cartilage palisades and composite cartilage–perichondrial island grafts. There are many variations on the shape, size and thickness of the cartilage grafts. The perceived benefit of cartilage tympanoplasty is to prevent retraction pockets at the grafted site, even though many otologists accept that this technique may not deal with the causal factors involved in the retraction process. Concerns that the stiffness and mass of cartilage grafts may adversely affect hearing have not been substantiated in clinical reports thus far.

Keywords

Cartilage TympanoplastyOssiculoplastyCanal Wall ReconstructionMyringoplasty
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 7 , July 2008 , pp. 663 - 672
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Ghanem, MA, Monroy, A, Alizadeh, FS, Nicolau, Y, Eavey, RD. Butterfly cartilage graft inlay tympanoplasty for large perforations. Laryngoscope 2006;116:1813–16CrossRefGoogle ScholarPubMed
2 Jansen, C. The use of cartilage in hearing restorative operations [in German]. In: 7th International Congress of Otology, Rhinology and Laryngology 1961. Paris: 1961Google Scholar
3 Salen, B. Myringoplasty using septum cartilage. Acta Otolaryngol 1963; (suppl 188):82–91Google Scholar
4 Jansen, C. Cartilage tympanoplasty. Laryngoscope 1963;13:1288–1302CrossRefGoogle Scholar
5 Heermann, J. The author's experience of using free temporalis fascia and the cartilage bridge from stapes to tympanic membrane for tympanoplasty and the reduction of radical mastoid cavity [in German]. Zeitschrift fur Laryngologie, Rhinologie und Otologie 1962;41:141–55Google Scholar
6 Heermann, J. Autogaft tragal and conchal palisade cartilage and perichondrium in tympanomastoid reconstruction. Ear Nose Throat J 1992;71:344–9CrossRefGoogle ScholarPubMed
7 Heermann, J. Cone tympanoplasty by several pieces after radical operation: cartilage bridge (plate) from stapes to the lower annulus: Hearing with a thicker drum [in German]. Archiv fur Ohr Nase und Kehlkopfheilkunde 1962;180:556–62CrossRefGoogle Scholar
8 Heermann, J. Seven years experience of using fascia and cartilage ‘roof tiles’ in tympanoplasty and antrum-mastoidplasty [in German]. Zeitschrift fur Laryngologie, Rhinologie und Otologie 1967;46:370–82Google Scholar
9 Guildford, FR, Shortreed, R, Halpert, B. Implantation of autogenous bone and cartilage into bullae of dogs. Arch Otolaryngol Belg 1966;84:144–7CrossRefGoogle Scholar
10 Symth, GDL, Kerr, AG. Cartilage homografts. Experimental and clinical aspects. Acta Oto-Rhino-Laryngologica Belgica 1970;24:53–9Google Scholar
11 Symth, GDL, Kerr, AG, Pahor, A, Law, K. Ossiculotympanic transplantation. Laryngoscope 1975;85:540–50CrossRefGoogle Scholar
12 Don, A, Linthicum, FH. The fate of cartilage grafts for ossicular reconstruction in tympanoplasty. Ann Otol Rhinol Laryngol 1975;84:187–91CrossRefGoogle ScholarPubMed
13 Schuknecht, HF, Shi, SR. Surgical pathology of middle ear implants. Laryngoscope 1985;95:249–58CrossRefGoogle ScholarPubMed
14 Elwany, S. Histochemical study of cartilage autografts in tympanoplasty. J Laryngol Otol 1985;99:637–42CrossRefGoogle ScholarPubMed
15 Steinbach, E, Pusalkar, A. Long-term histological fate of cartilage in ossicular reconstruction. J Laryngol Otol 1981, 95:1031–9CrossRefGoogle ScholarPubMed
16 Brockman, SJ. Cartilage graft tympanoplasty type III. Laryngoscope 1965;75:1452–61CrossRefGoogle Scholar
17 Goodhill, V. Tragal perichondrium and cartilage in tympanoplasty. Arch Otolaryngol 1967;85:480–91CrossRefGoogle ScholarPubMed
18 Eviatar, A. Tragal perichondrium and cartilage in reconstructive ear surgery. Laryngoscope 1978;88 (suppl 11):1–23CrossRefGoogle ScholarPubMed
19 Altenau, MM, Sheehy, JL. Tympanoplasty, cartilage prostheses – a report of 564 cases. Laryngoscope 1978;88:895–904CrossRefGoogle ScholarPubMed
20 Quaranta, N, Feijoo, SF-V, Piazza, F, Zini, C. Closed tympanoplasty in cholesteatoma surgery: long-term (10 years) hearing results using cartilage ossiculoplasty. Eur Arch Otorhinolaryngol 2001;258:20–4CrossRefGoogle ScholarPubMed
21 Chole, RA, Kim, H-J. Ossiculoplasty with presculptured banked cartilage. Operative Techniques in Otolaryngology–Head and Neck Surgery 1966;7:38–4CrossRefGoogle Scholar
22 Heermann, J. Auricular cartilage palisade tympano-, epitympano-, antrum- and mastoid-plasties. Clin Otolaryngol 1978;3:443–6CrossRefGoogle ScholarPubMed
23 Heermann, J, Heermann, H, Kopstein, E. Fascia and cartilage palisade tympanoplasty. Arch Otolaryngol 1970;91:228–41CrossRefGoogle ScholarPubMed
24 Overbosch, HC. Homograft myringoplasty with micro-sliced septal cartilage. Practica Oto-Rhino-Laryngologica 1971;33:356–7Google ScholarPubMed
25 Amedee, RG, Mann, WJ, Eiechelmann, H. Cartilage palisade tympanoplasty. Am J Otol 1989;10:447–50Google ScholarPubMed
26 Milewski, C. Composite graft tympanoplasty in the treatment of ears with advanced middle ear pathology. Laryngoscope 1993;103:1352–6CrossRefGoogle ScholarPubMed
27 Dornhoffer, J. Cartilage tympanoplasty: indications, techniques, and outcomes in a 1,000-patient series. Laryngoscope 2003;113:1844–56CrossRefGoogle Scholar
28 Murbe, D, Zahnert, T, Bornitz, M, Huttenbrink, KB. Acoustic properties of different cartilage reconstruction techniques of the tympanic membrane. Laryngoscope 2002;112:1769–76CrossRefGoogle ScholarPubMed
29 Duckert, LG, Muller, J, Makielski, KH, Helms, J. Composite autograft “shield” reconstruction of remnant tympanic membranes. Am J Otol 1995;16:21–6Google ScholarPubMed
30 Dornhoffer, JL. Hearing results with cartilage tympanoplasty. Laryngoscope 1997;107:1094–99CrossRefGoogle ScholarPubMed
31 Spielmann, P, Mills, R. Surgical management of retraction pockets of the pars tensa with cartilage and perichondrial grafts. J Laryngol Otol 2006;120:725–9CrossRefGoogle ScholarPubMed
32 Shin, S-H, Lee, W-S, Kim, H-N, Lee, H-K. Wheel-shaped cartilage-perichondrium composite graft for the prevention of retraction pocket development. Acta Otolaryngol (Stockh) 2007;127:25–8CrossRefGoogle ScholarPubMed
33 Eavey, RD. Inlay tympanoplasty: cartilage butterfly technique. Laryngoscope 1998;108:657–61CrossRefGoogle ScholarPubMed
34 Neumann, A, Jahnke, K. Tympanic membrane reconstruction using cartilage – indications, techniques and results [in German]. HNO 2005;53:573–84CrossRefGoogle ScholarPubMed
35 Hartwein, J, Leuwer, RM, Kehrl, W. The total reconstruction of the tympanic membrane by the “crowncork” technique. Am J Otolaryngol 1992;13:172–5CrossRefGoogle ScholarPubMed
36 Linde, RE. The cartilage-perichondrium graft in the treatment of posterior tympanic membrane retraction pockets. Laryngoscope 1973;83:747–53CrossRefGoogle ScholarPubMed
37 Glasscock, ME, Jackson, CG, Nissen, AJ, Schwaber, MK. Postauricular undersurface tympanic membrane grafting: a follow-up report. Laryngoscope 1982;92:718–27CrossRefGoogle ScholarPubMed
38 Adkins, WY. Composite autograft for tympanoplasty and tympanomastoid surgery. Laryngoscope 1990;100:244–7CrossRefGoogle ScholarPubMed
39 Fernandes, SV. Composite chondroperichondrial clip tympanoplasty: the triple “C” technique. Otolaryngol Head Neck Surg 2003;128:267–72Google ScholarPubMed
40 Gierek, T, Slaska-Kaspera, A, Majzel, K, Klimczak-Gotqb, L. Results of myringoplasty and type I tympanoplasty with the use of fascia, cartilage and perichondrium grafts [in Polish]. Otolaryngologia Polska 2004;3:529–33Google Scholar
41 Anderson, J, Caye-Thomasen, P, Tos, M. A comparison of cartilage palisades and fascia in tympanoplasty after surgery for sinus or tensa retraction cholesteatoma in children. Otol Neurotol 2004;25:856–63CrossRefGoogle ScholarPubMed
42 Gerber, MJ, Mason, JC, Lambert, PR. Hearing results after primary cartilage tympanoplasty. Laryngoscope 2000;110:1994–9CrossRefGoogle ScholarPubMed
43 Couloigner, V, Baculard, F, El Bakkouri, W, Viala, P, Francois, M, Narcy, P et al. Inlay butterfly cartilage tympanoplasty in children. Otol Neurotol 2005;26:247–51CrossRefGoogle ScholarPubMed
44 Zahnert, T, Huttenbrink, K-B, Murbe, D, Bornitz, M. Experimental investigations of the use of cartilage in tympanic membrane reconstruction. Am J Otology 2000;21:322–8CrossRefGoogle ScholarPubMed
45 McCleve, DE. Tragal cartilage reconstruction of the auditory canal. Arch Otolaryngol 1969;90:271–4CrossRefGoogle Scholar
46 McCleve, DE. Repair of bony canal wall defects in tympanomastoid surgery. Am J Otol 1985;6:76–9Google ScholarPubMed
47 Adkins, WY, Osguthorpe, JD. Composite autograft used to prevent recurrent cholesteatoma. Otolaryngol Head Neck Surg 1984;92:319–21CrossRefGoogle ScholarPubMed
48 Levinson, RM. Cartilage-perichondrial composite graft tympanoplasty in the treatment of posterior marginal and attic retraction pockets. Laryngoscope 1987;97:1069–74CrossRefGoogle ScholarPubMed
49 Poe, DS, Gadre, AK. Cartilage tympanoplasty for management of retraction pockets and cholesteatomas. Laryngoscope 1993;103:614–18CrossRefGoogle ScholarPubMed