Preparation and placement of cartilage island graft in tympanoplasty

Introduction: Cartilage graft tympanoplasty has a better success rate in the treatment of chronic otitis media if regularly prepared and placed. Objective: To prepare cartilage island material and evaluate its effect on the success rate of tympanoplasty. Methods: The medical records of 87 patients (48 males and 39 females; mean age, 27.3 ±11.2 years; range, 14–43 years) with chronic otitis media without cholesteatoma who underwent intact canal-wall-up tympanoplasty and revision surgery between December of 2007 and October of 2011 were retrospectively evaluated. Surgery was performed under general anesthesia via a retroauricular approach. Results: The overall success rate of this technique was 93% in terms of perforation closure. No graft lateralization or displacement into the middle ear occurred. The overall average preoperative air bone gap was 37.27 ± 12.35 dB, and the postoperative air bone gap was 27.58 ± 9.84 dB. The mean postoperative follow-up period was 15.3 months (range: 7–21 months). Conclusion: If cartilage graft is properly prepared and placed, cartilage graft tympanoplasty appears to provide better success rates and hearing results.

引言：软骨移植鼓室成形术（cartilage graft tympanoplasty）若制备与放置规范，则其治疗慢性中耳炎（chronic otitis media）的成功率更高。
研究目的：制备软骨岛材料（cartilage island material），并评估其对鼓室成形术成功率的影响。
方法：回顾性分析2007年12月至2011年10月期间，87例无胆脂瘤（cholesteatoma）的慢性中耳炎患者的临床病历资料，其中男性48例、女性39例，平均年龄27.3±11.2岁，年龄范围14~43岁；所有患者均接受完壁式鼓室成形术（intact canal-wall-up tympanoplasty）及翻修手术，手术均在全身麻醉下经耳后入路实施。
结果：该术式在鼓膜穿孔闭合方面的总体成功率达93%，未出现移植物外侧移位或突入中耳腔的情况。术前总体平均气骨导差（air bone gap）为37.27±12.35 dB，术后气骨导差为27.58±9.84 dB；术后平均随访时长为15.3个月，随访范围7~21个月。
结论：若软骨移植物制备及放置规范，软骨移植鼓室成形术可获得更高的手术成功率与更佳的听力预后。