Double-Layer Tympanic Membrane Graft in Type I Tympanoplasty.

Ann Otol Rhinol Laryngol 2019 Sep 16;128(9):795-801. Epub 2019 Apr 16.

4 Addis Ababa University, Tikkur Anbessa, Addis Ababa, Ethiopia.

Background: Some discussion remains among otologists regarding the best grafts for tympanic membrane closure. It is unclear whether double-layer grafts are superior to single-layer and whether single-layer cartilage is superior to fascia or perichondrium alone. The objective of the current study was to examine the relative efficacy of single-layer versus double-layer tympanic membrane grafting techniques.

Materials And Methods: A retrospective review of the medical records was used to address the objective of the study. Patients operated on in an over/under technique by the same surgeon underwent single-layer perichondrium or single-layer perichondrium with a cartilage island, or a double-layer of perichondrium combined with periochondrium with a cartilage island. The outcomes assessed were tympanic membrane reperforation and hearing improvement.

Results: A total of 135/177 (76%) perichondrium grafts had no reperforation, and 43/55 (78%) perichondrium with cartilage island grafts had no reperforation; 352/390 (90%) of the double-layer closures had no reperforation. There was no statistically significant difference in reperforation rates between the 2 single-layer techniques ( = .926). The difference in reperforation rates after the double-layer closure versus the perichondrium single-layer closure was statistically significant ( = .001), as was the difference in reperforation rates after the double-layer closure versus the cartilage island single-layer closure ( = .02). All 3 groups showed statistically significant hearing improvement postoperatively ( < .0001). Preoperative hearing levels ( = .179), postoperative hearing ( = .857), and decibels of hearing improvement ( = .356) were the same for all 3 groups.

Conclusion: Double-layer closure gives lower tympanic membrane reperforation rates than does single-layer closure, as well as similar hearing outcomes.

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003489419843551DOI Listing
September 2019
13 Reads

Publication Analysis

Top Keywords

tympanic membrane
20
cartilage island
16
reperforation rates
16
single-layer closure
12
double-layer closure
12
difference reperforation
12
single-layer
9
double-layer
8
grafts reperforation
8
hearing improvement
8
closure versus
8
membrane reperforation
8
rates single-layer
8
double-layer tympanic
8
single-layer perichondrium
8
perichondrium single-layer
8
reperforation
8
perichondrium cartilage
8
rates double-layer
8
perichondrium
7

References

(Supplied by CrossRef)

H√ľnermann T et al.
1970

Kouhi A et al.
Iran J Otorhinolaryngol 2018

Sengupta A et al.
Indian J OHNS 2012

Similar Publications