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

ABSTRACT

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