[Reinforcing tympanoplasty with cartilage mosaic (differences from the palisade technique)]. / Tympanoplastie de renforcement en mosaïque de cartilage (différences avec la technique en palissade).

OBJECTIVES: To demonstrate the interest of cartilage mosaic tympanoplasty in the reconstruction of the tympanic membrane. MATERIALS AND METHODS: Retrospective series of 103 patients; the authors analyzed their results after cartilage mosaic tympanoplasty, with a mean follow up of 3.5 years (3 to 7 years). They explain the surgical technique in detail. The average gain was calculated on the difference of the pre-and post-operative thresholds in air conduction on the four frequencies 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz. RESULTS: The authors detail and analyze their anatomical and audiologic results. The total rate of closing of the tympanic membrane is 93.2%, accounting for 96 perforations closed among 103. A tympanic retraction sitting apart from the reinforced zone was noted in 0.97%, representative only one case of 103. Then the total rate of success is 92.23%, representing 8 failures of 103. The average pre- and post-operative air bone gap were 26.5 dB and 14.6 dB. The average gain was 12.5 dB (extremes of 0 dB to 40 dB). CONCLUSION: The authors show the great reliability of cartilage mosaic tympanoplasty to reconstruct the tympanic membrane. They widen the indications with all types of tympanoplasties. Especially with the recurrent perforations, and the perforations evolving in an inflammatory context and/or dysfunction of the Eustation tube. Their results show a major interest to use this technique in the anterior and inferior perforations, and whatever the ossicular chain status.

[The pedicled musculo-cutaneous latissimus dorsi flap]. / Le lambeau musculo-cutané pédiculé du grand dorsal.

The pedicled musculo-cutaneous latissimus dorsi flap presents many advantages and merits to be used more frequently in head and neck surgery because a large musculo-cutaneous pallet with an excellent vitality can be obtained. The flap reaches easily the inferior third of the face thanks to its rotation arc, leading to a discreet aesthetic scar. For this reason, its use is interesting especially for women. The aim of this article is to focus on the fundamental points of the technique we use and to emphasize the importance of the postoperative patient's arm positions to obtain a good result.