Original article： Perichondrium/cartilage composite graft for repairing large tympanic membrane perforations and hearing improvement  

作　　者：CHEN Xiao-wei YANG Hua GAO Ru-zhen YU Rong GAO Zhi-qiang 

机构地区：[1]Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

出　　处：《Chinese Medical Journal》2010年第3期301-304,共4页中华医学杂志（英文版）

摘　　要：Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringitis that require middle ear exploration and mastoidectomy. The aim of this study was to investigate a novel technique of perichondrium/cartilage composite graft for repairing the large TM perforation in the patient of otitis media. Methods Retrospective chart reviews were conducted for 102 patients with large tympanic membrane perforations, who had undergone tympanoplasty from August 2005 to August 2008. Tympanoplasty or tympanomastoidectomy using a perichondrium/cartilage composite graft was analyzed. The tragal or conchal perichondrium/cartilage was used to replace the tympanic membrane in patients. Results Patients aged from 13 to 67 years were followed up in average for 24 months （10-36 months）. Seventy-four ears （72.61%） were used the tragal perichondrium/cartilage as graft material and 27 ears （27.39%） were used the conchal perichondrium/cartilage. Graft take was successful in all patients. Postoperative complications such as wound infection, hematoma, or sensorineural hearing loss were not identified. Nine patients （8.82%） had the partial ossicular replacement prosthesis, 14 patients （13.72%） using the autologous curved incus and 79 patients （77.45%） without prosthesis. Successful closure occurred in 92% of the ears. A total of 85.8% patients achieved a postoperative hearing improvement. Conclusions The graft underlay tympanoplasty using perichondrium/cartilage composite is effective for the majority of patients with large perforation. The hearing was improved even if the mastoidectomy was required in the patients with otitis media with extensive granulation.Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringitis that require middle ear exploration and mastoidectomy. The aim of this study was to investigate a novel technique of perichondrium/cartilage composite graft for repairing the large TM perforation in the patient of otitis media. Methods Retrospective chart reviews were conducted for 102 patients with large tympanic membrane perforations, who had undergone tympanoplasty from August 2005 to August 2008. Tympanoplasty or tympanomastoidectomy using a perichondrium/cartilage composite graft was analyzed. The tragal or conchal perichondrium/cartilage was used to replace the tympanic membrane in patients. Results Patients aged from 13 to 67 years were followed up in average for 24 months （10-36 months）. Seventy-four ears （72.61%） were used the tragal perichondrium/cartilage as graft material and 27 ears （27.39%） were used the conchal perichondrium/cartilage. Graft take was successful in all patients. Postoperative complications such as wound infection, hematoma, or sensorineural hearing loss were not identified. Nine patients （8.82%） had the partial ossicular replacement prosthesis, 14 patients （13.72%） using the autologous curved incus and 79 patients （77.45%） without prosthesis. Successful closure occurred in 92% of the ears. A total of 85.8% patients achieved a postoperative hearing improvement. Conclusions The graft underlay tympanoplasty using perichondrium/cartilage composite is effective for the majority of patients with large perforation. The hearing was improved even if the mastoidectomy was required in the patients with otitis media with extensive granulation.

关 键 词：otitis media perichondrium/cartilage TYMPANOPLASTY tympanomastoidectomy hearing improvement 

分 类 号：Q513.2[生物学—生物化学] TQ327.9[化学工程—合成树脂塑料工业]