Cartilage and Fascia Graft In Type 1 Tympanoplasty: Comparison of Anatomical and Audological Results.

Tympanoplasty is a surgical procedure aiming to reconstruct the tympanic membrane and hearing. The aim of this study was to compare anatomic and audiological results of cartilage graft with temporal fascia graft in type 1 tympanoplasty patients. We conducted a descriptive, retrospective study of medical records of patients who underwent tympanoplasty between January 2010 and December 2015 at the Department of Otolaryngology Head and Neck Surgery of Farhat Hached University Hospital. In total, we obtained 46 patients. Twenty-three patients who underwent type 1 cartilage tympanoplasty using cartilage graft were compared with 23 patients in whom temporal muscle fascia was used. In follow-up, residual perforation occurred in 1 of 23 patients (4.3%) undergoing cartilage tympanoplasty and in 2 of 23 patients undergoing fascia tympanoplasty (8.7%), which was found to be statistically non significant (P > 0.05). In both cartilage and fascia groups, when they were compared in terms of gain, no significant difference was found between groups (P = 0.271), air bone gap gain was found to be 12.9 ±9.9 decibels in cartilage group, whereas it was 10 ±â€Š6.6 decibels in fascia group. Operation success is defined by successful anatomical and functional outcome. Among all patients, 35 (76%) were reported to have operation success. It was established that type of operation had no significant influence on success (P = 0.73). Currently, there is an increasing interest in using cartilage grafts in primary tympanoplasty. Especially, in patients with severe middle ear pathology, cartilage graft should be used routinely without risk on influencing audiological results.

Laryngeal synovial sarcoma: Report of 2 cases.

Synovial sarcoma is a malignant mesenchymal tumor. It most commonly occurs in the lower extremities of young adults. The head and neck are rare sites, accounting for less than 10%. The larynx is an extremely rare site. We report two cases of 27 and 18 year-old men who developed a synovial sarcoma of the larynx. They presented with hoarseness of voice and hemoptysis. Endoscopy detected a mass in the supraglottic region. The biopsy concluded a synovial sarcoma. Immunohistochemistry conveyed diagnostic certainty. They had been treated with total laryngectomy and post-operative radiotherapy. The 2 patients are seen for regular follow-ups in our department and they remained recurrence-free for 10 years and 24 months, respectively. Synovial sarcoma is a very rare tumor of the larynx. A multidisciplinary therapeutic approach is essential for the management of this malignancy. Long-term follow-up is required to monitor for recurrence and improve disease-free survival.