Reconstruction of subtotal and total tympanic membrane perforations using cartilage palisade technique

The purpose of this study was to evaluate the use of palisade cartilage technique for reconstruction of subtotal and total tympanic membrane [TM] perforations compared with temporalis fascia [TF] graft. Prospective study consists of ninety five patients suffering from chronic inactive suppurative otitis media with subtotal and total TM perforations. The patients underwent full history taking, clinical examination and audiological evaluation. The patients were classified into two groups: group A [75 patients] in whom cartilage palisade technique was used and group B [20 patients] in whom TF graft was used. Closure of TM perforation was achieved in 71 patients [94.6%] of group A and in 7 patients [35%] in group B. As regards hearing results, there was highly significant postoperative improvement in pure tone averages as well as air-bone gap averages in both groups. In group A, the air-bone gap was closed to less than 10 dB in 26.6% and from 10-25 dB in 56% and to more than 25dB in 17.4%. While in group B, the air-bone gap was closed to less than 10 dB in 25% and from 10 - 25 dB in 65% and to more than 25dB in 10%. In this study, the average pre and postoperative air-bone gap were 26.1 dB and 13 dB respectively for cartilage group and 25.3 dB and 13.1 dB for fascia group. This study revealed that, the palisade technique is an effective, straight foreword technique with high success rate and good hearing results without postoperative complications

Myringoplasty in children: predictive value of preoperative assessment of Eustachian tube function

Our aim was to determine the value of preoperative Eustachian tube [ET] function assessment in predicting the results of myringoplasties in children. One hundred children suffering from inactive chronic suppurative otitis media were enrolled in this study. All children had undergone preoperative evaluation of the ET function using pressure equalizing test. Children were classified into three groups according to the ET function. The patients were operated at ORL Departments, Mansoura and Banha University hospitals between 2003 and 2006. Tympanic membrane perforations were reconstructed by autogenous temporalis fascia graft using underlay technique. Success was defined as no evidence of tympanic membrane perforation via otoscopic examination at the end of 6th month and air bone gap less than 20 dB. A success rate of 91.6% in terms of graft uptake and hearing improvement of 95.4% was seen in good ET function, compared to 36.4% graft uptake and 62.5% hearing improvement in poor ET function. This study revealed that preoperative assessment of ET function is an important factor when considering myringoplasty in children