Application of Tragus Cartilage Ring-Perichondrium in Tympanoplasty and
Analysis of Related Factors Affecting its Long-Term Outcomes
Abstract
Objective To report repair of large tympanic membrane perforation using
tragus cartilage ring-perichondrium grafts and factors that can affect
the long-term outcomes. Methods From January 2004 to December 2013,
tragus Cartilage ring perichondrium grafts were used during
myringoplasty in 325 patients (375 ears). Their clinical data, including
age, duration of dry ear, preoperative air conduction hearing threshold,
postoperative bone conduction hearing threshold, tympanic mucosa
condition, tympanosclerosis lesions, ossicular chain lesion, Eustachian
tube function, intraoperative blood oozing and follow-up data (more than
3 years), were analyzed using the SPSS 16.2 software. χ2 test and
multiple linear regression analysis were employed with P<0.05
being statistically significant. Results The mean age of our patients
was 36±8.32 (11-62) years and the average disease duration was 21±7.62
(1-36) years. The rate of tympanic membrane healing was 94.8% at 1 year
and 91.6% at 3 years. Multivariate analysis of factors influencing
operation results indicated correlation to the following:
tympanosclerotic plaque lesions, preoperative air conduction hearing
threshold, preoperative bone conduction hearing threshold, duration of
disease, eustachian tube function and intraoperative blood oozing.
Conclusion Tympanosclerotic plaque lesions, preoperative air conduction
hearing threshold, duration of disease, eustachian tube function and
intraoperative blood oozing appear to affect the efficacy of
tympanoplasty using tragus cartilage ring-perichondrium grafts. Key
point 1.Tympanic membrane grafts in tympanoplasty are usually tragus
perichondrium or temporomandibular fascia. 2.Some experts use
cartilage-perichondrium as a graft, but it increases the quality of
tympanic membrane, which will also have a certain impact on hearing
recovery. 3.An expert group was convened to study how to remove the
cartilage with a diameter of 5mm in the center, keep the cartilage ring
with a width of 1.5mm in the periphery, and repair it into a cartilage
ring-perichondrium complex, so as to reduce the influence of excessive
thickness of the whole cartilage on postoperative hearing. 4.After more
than 3 years’ follow-up,Multiple linear regression was used for
analysis, and the factors influencing the operation effect were
observed. 5.This study confirmed that in tympanoplasty, tragus cartilage
ring-perichondrium is used as a graft, which is especially suitable for
patients with tympanic membrane perforation.