Chondro-perichondrial connection in middle ear surgery.

Hearing conservation or gain are important parameters of tympanoplastic surgery. The frequency of this surgical procedure and the difficulty in obtaining tissues due to the increased risk of H.I.V. transfer has made the use of synthetic products somewhat more acceptable in contrast with the use of organic substances (homograft ossicles, bone, cartilage and perichondrium, etc...). We have been using tissues of the same patient (50), during a period of three years with a specimen constituted of cartilage and perichondrium designed as a "butterfly" and with very promising tympanoplastic and functional results. The tympanoplastic results were evaluated eighteen months postoperatively as follows: good: 86%, aural discharges that disappeared later 12%, perforations: 0%, keratin neoformations: 2%. Functional results were evaluated three years later as follows: gain more than 15 dB: 72%, same: 14%, worse: 14%.

[Chondro-perichondrial connections in otic surgery (CPC)]. / Conexiones condropericóndricas en la cirugía ótica (CCP).

Tympanoplasty does not resolve problems such as tympanic reconstruction, pneumatic cavity and ossicular transmission mechanism. With the purpose to solve these problems, we used autografts of tragal cartilage with its perichondrial membrane. In just one surgical procedure, we built a transmission mechanism and a consistent new tympanic membrane. Results obtained after 2 years of experience are very encouraging, since postoperative auditive function improves up to 75%; also, a good pneumatic cavity and a well vascularized new tympanic membrane are achieved. Reabsorption of the cartilage was not seen in any case.

[Computerized study of perioperative difficulties of stapedectomy]. / Estudio computarizado de las dificultades perquirúrgicas de la estapedectomía.

A retrospective study of 1035 stapedectomies was performed to assess the incidence of intraoperative complications between 1972-1990. We found 45.89% of complications. We divided this alterations in 6 groups: 1) hemorrhage (20.67%), 2) stapes, foot plate, oval window (8.40%), 3) alterations in the middle ear (6.85%), 4) alterations in the incus (3.76%), 5) alterations in the external ear canal (3.57%) and 6) problems with protesis or graf (2.60%). We have analyzed these complications. We propose to carry out the solutions.