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Ring versus ‘Mercedes-Benz’ cartilage-perichondrium graft tympanoplasty in management of pars tensa cholesteatoma

Published online by Cambridge University Press:  29 September 2011

O A Albirmawy
O A Albirmawy*
Affiliation:
Otolaryngology Department, Tanta University Hospital, Egypt
*
Address for correspondence: Dr O A Albirmawy, Reyad St 88, Tanta, 31211, Gharbeya, Egypt E-mail: albirmawy@hotmail.com
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Abstract

Objective:

To compare anatomical and audiological outcomes of ring versus ‘Mercedes-Benz’ cartilage-perichondrium graft tympanoplasty in patients with pars tensa cholesteatoma.

Study design:

Prospective clinical study.

Setting:

Otolaryngology department, Tanta University Hospital, Egypt.

Patients and methods: Over three years, 60 ears in 60 patients underwent surgery for either sinus or tensa retraction cholesteatoma, reconstructed using either a ring-shaped (30 ears) or Mercedes-Benz symbol shaped (30 ears) cartilage-perichondrium graft, with at least two years' follow up. Post-operative drum perforation and retraction, cholesteatoma residue and recurrence, middle-ear effusion, and hearing acuity were monitored.

Results:

Anatomical outcomes were equivalent in both groups, but slightly better in the Mercedes group. Hearing improved significantly in both groups (pre- vs post-operative results), but significantly more so in the ring group. Within-group hearing outcomes were unaffected by cholesteatoma type or tympanoplasty type.

Conclusion:

The Mercedes-Benz technique may be superior to the ring technique in preventing neodrum retraction. However, the ring graft technique had better hearing outcomes, perhaps due to its more physiological design.

Keywords

CholesteatomaTympanoplastyGraftCartilage
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 12 , December 2011 , pp. 1232 - 1238
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Uzun, C, Cayé-Thomasen, P, Andersen, J, Tos, M. A tympanometric comparison of tympanoplasty with cartilage palisades or fascia after surgery for tensa cholesteatoma in children. Laryngoscope 2003;113:1751–7CrossRefGoogle ScholarPubMed
2Uzun, C, Yagiz, R, Tas, A, Adali, MK, Koten, M, Karasalihoglu, AR. Combined Heermann and Tos (CHAT) technique in cholesteatoma surgery: surgical technique and preliminary results. J Laryngol Otol 2005;119:429–35CrossRefGoogle ScholarPubMed
3Cayé-Thomasen, P, Andersen, J, Uzun, C, Hansen, S. Ten-year results of cartilage palisades versus fascia in eardrum reconstruction after surgery for sinus or tensa retraction cholesteatoma in children. Laryngoscope 2009;119:944–52CrossRefGoogle ScholarPubMed
4Dornhoffer, JL. Cartilage tympanoplasty: indications, techniques, and outcomes in a 1,000 patient series. Laryngoscope 2003;113:1844–56CrossRefGoogle Scholar
5Mansour, MH, Askar, MH, Albirmawy, OA. How I do it. Repair of tympanic membrane perforation using a modified cartilage-perichondrium composite ring graft. J Laryngol Otol 2006;120:952–4CrossRefGoogle Scholar
6Albirmawy, OA. Comparison between cartilage-perichondrium composite ‘ring’ graft and temporalis fascia in type one tympanoplasty in children. J Laryngol Otol 2010;124:967–74CrossRefGoogle ScholarPubMed
7Albirmawy, OA, Erfan, FA. Combined intact bridge mastoidectomy with ring graft tympanoplasty. J Otolaryngol Head Neck Surg 2011;40:122–30Google Scholar
8Spielmann, P, Mills, R. Surgical management of retraction pockets of the pars tensa with cartilage and perichondrial grafts. J Laryngol Otol 2006;120:725–9CrossRefGoogle ScholarPubMed
9Anderson, J, Cayé-Thomasen, P, Tos, M. A comparison of cartilage palisades and fascia in tympanoplasty after surgery for sinus or tensa retraction cholesteatoma in children. Otol Neurotol 2004;25:856–63CrossRefGoogle ScholarPubMed
10Dornhoffer, JL. Cartilage tympanoplasty. Otolaryngol Clin North Am 2006;39:1161–76CrossRefGoogle ScholarPubMed
11Siddiq, MA, East, DM. Long-term hearing results of incus transposition. Clin Otolaryngol 2004;29:115–18CrossRefGoogle ScholarPubMed
12Stankovic, M. Follow-up of cholesteatoma surgery: open versus closed tympanoplasty. ORL J Otorhinolaryngology Relat Spec 2007;69:299–305CrossRefGoogle ScholarPubMed