Cartilage Island Graft Tympanoplasty in Advanced Middle Ear Disease: Anatomic and Audio logic Results

Objective: To present the experience in cartilage island graft tympanoplasty for advanced middle ear pathologies and evaluate its success rate and audiologic results. Materials and Methods: The charts of patients who underwent cartilage island graft tympanoplasty for advanced middle ear disease from September 2006 to March 2009 were reviewed and only oto-endoscopy assisted intact canal wall (ICW) / type 3 tympanoplasty procedures have been included in this study. Reviewed parameters were graft take, change between the pre- and post operative pure tone average air bone gap (PTA-ABG) and complications. Audio logic evaluation was made among the patients whom complete ear drum closure was achieved Results: Of the 36 procedures, 63.9% were for chronic otitis media with cholesteatoma, 11.1% for chronic otitis media with polyp, 25% for adhesive otitis/retraction pocket with or without cholesteatoma. TORP was used in 14 cases and PORP in 22. Graft take was achieved 88.9% of the patients. There were two attic perforation with cholesteatoma and two anterior perforation. The overall pre-and postoperative PTA-ABG were 28.91 +/- 8.73 dB and 10.42 +/- 6.10 dB. PORP subgroups had a statistically signifcant better hearing results at 0.5 kHz, 4.0 kHz and average. Conclusion: Results in our study indicate that cartilage island graft is a reliable material in advanced middle ear pathologies with satisfactory anatomical - functional outcomes and it reduces the risk of retraction pockets which can lead to recurrent cholesteatoma.