Subscribe to RSS
DOI: 10.1055/s-0042-1746922
Cartilaginous bending spring tympanoplasty in anterior and subtotal defects of the tympanic membrane – a temporal bone study and first clinical Results
Introduction
Recently, the cartilaginous bending spring tympanoplasty for anterior or subtotal tympanic membrane perforations proposed the use of a cartilage strut graft forming a U-shaped bending spring to prevent medialization of the cartilaginous tympanic membrane graft. However, audiological properties and success rates of this new method have not been addressed yet.
Materials and Methods
Six human temporal bones were prepared with an underlay cartilage in the anterior part of the tympanic membrane supported by a cartilaginous bending spring. The middle ear transfer functions were measured using laser doppler vibrometry.
For clinical evaluation, 23 ears in 21 patients with chronic otitis media and intact ossicular chain were operated using cartilaginous bending spring tympanoplasty.
Results
Measured stapes velocities at one-third octave midband frequencies averaged 3.563 x10<sup>-2</sup> ± 9.455 x10<sup>-3</sup> [mm/s/Pa] compared to 3.063 x10<sup>-2</sup> ± 6.864 x10-3 [mm/s/Pa] with the bending and underlay cartilage in place (p = 0.319). The bending spring tympanoplasty reduced the transfer function by 1.41 ± 0.98 dB on average.
In the clinical part of the study, successful closure of the tympanic membrane was achieved in 22 out of 23 patients (96 %) after a mean follow up of 5.8 ± 2.4 months (min. 3.5 mo, max. 12.0 mo). The air-bone gap improved significantly by 6.2 dB (± 6.6 dB; p < 0.001), as well as word recognition score @ 65 dB from 61.8 ± 33.3 % preoperatively to 80.0 ± 20.9 % postoperatively (p = 0.031).
Conclusion
Experimental data as well as initial clinical results suggest that cartilaginous bending spring is an effective method for reconstruction of anterior or subtotal defects of the tympanic membrane with satisfactory audiologic results and closure rates.
#
Conflict of Interest
The author declares that there is no conflict of interest.
Publication History
Article published online:
24 May 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart,Germany