Tympanoossicular reconstruction in chronic noncholesteatomatous diseases of the middle ear

摘要

Abstract Introduction: The surgical reconstruction of the tympanoossicular system is named tympanoplasty. This includes the grafting of the tympanic membrane, named myringoplasty and the reconstruction of the ossicular chain through different types of ossiculoplasties. The objectives were to compare the results obtained with different types of grafting materials, we used in the reconstruction of the tympanic membrane and with different ossiculoplasty procedures. Methods: The study includes a total of 115 tympanoplasties in patients with noncholesteatomtous disease of the middle ear. In 31 of these cases the reconstruction of the ossicular chain was necessary. We used temporalis fascia for the reconstruction of the tympanic membrane in 42 cases and tragal perichondrium in 15. In the last years we introduced cartilage as grafting material and we used it in 58 tympanic membrane reconstructions. Incus interposition was the most frequently used ossiculoplasty procedure.Results: The rate of postoperative perforations and drum retractions was somewhat lower with the cartilage technique. The hearing results were comparable, but depended a lot on the status of the ossicular chain.Conclusion: In poor ventilated ears and in subtotal perforations cartilage seems to be a good option for eardrum reconstruction. The incus interposition is still a reliable method, if the ossicle is available and the basic situation is favorable.