Publication:

Results of cartilage shield tympanoplasty in revision cases of myringoplasty

Background Cartilage shield tympanoplasty (CST) is seen as a good option for revision surgery in cases of myringoplasty failure. Cartilage serves as rigid material which resists retraction. However, there have been concerns regarding hearing outcome and surveillance in follow up period.

Methods A prospective study was conducted at our tertiary institute. 25 patients of either sex in age group of 18-50 years with one or more failed tympanoplasties underwent CST. Pre-operative and post-operative audiograms were obtained, and patients were regularly followed up to calculate graft uptake and hearing outcome. Quantitative data was analyzed by using Student t-test and for qualitative data chi square test was used.

Results The mean pre-operative pure tone air-bone gap was 25.09±8.10 dB while the mean postoperative pure tone air-bone gap was 13.47±5.18 dB, one case (4%) presented with failure as there was a residual perforation antero-inferiorly. Since it was a small residual perforation, it was planned for closure by fat myringoplasty. No complications were recorded. We obtained graft take rate of 96% and mean postoperative gain of 11.62±7.11 dB in PTA-ABG.

Conclusions We recommend CST for revision cases of tympanoplasty.