Search

Objective: In this study, graft success, hearing outcome, and complications were compared following the repair of subtotal perforation using a cartilage reinforcement underlay technique (CRUT) versus the traditional cartilage underlay technique (TCUT)., Study Design: Randomized controlled trial., Materials and Methods: Seventy-six patients with subtotal perforations were prospectively randomized to the CRUT (n = 38) or TCUT (n = 38) group. The graft success rate, hearing outcome, and complications were compared at 12 months., Results: The mean operation time was 32.9 ± 4.2 (range: 26-47) min in the CRUT group and 51.8 ± 6.3 (range: 48-73) min in the TCUT group (P < 0.001). At 12 months postoperatively, no residual perforation was seen in either group. The graft success rate was 94.7 % (36/38) in the CRUT group and 92.1 % (35/38) in the TCUT group; the difference was not significant (P = 0.643). The postoperative air bone gap (ABG) was significantly improved compared to the preoperative value in both groups, without significant between-group differences in either the preoperative (P = 0.741) or postoperative (P = 0.865) ABG or the mean ABG gain (P = 0.812). Additionally, there were no significant between-group differences in the preoperative (P = 0.887) or postoperative (P = 0.753) mean bone-conduction pure tone average. In the TCUT group, seven (18.4 %) patients developed temporary hypogeusia and two (5.3 %) had external auditory canal scarring. Graft cholesteatoma was not observed in either group., Conclusion: In the treatment of subtotal perforations, lateral reinforcement of the annulus with additional cartilage is simpler than traditional cartilage underlay for achieving graft and hearing success. The technique also does not involve raising the tympanomeatal flap or removing perforation margins., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: The objective of this study was to compare the graft outcomes and complications of two endoscopic perichondrium-cartilage graft techniques for repairing large perforations., Study Design: Single center blinded randomized controlled trial., Materials and Methods: 61 large perforations more than 50% of TM area were prospectively randomized to undergo the free perichondrium and free cartilage graft group (FPFC, n = 31) or perichondrium partial attachment the cartilage graft group (PPAC, n = 30). The primary outcome measures were the operation time; secondary outcome measures were the graft success rate and hearing gain at 12 months postoperatively and postoperative complications., Results: All patients completed follow-up of 12 months. The mean operation time was 38.2 ± 2.3 min in the FPFC group and 37.4 ± 5.6 min in the PPAC group (P = 0.658). At postoperative 3 months, the graft success rates were 96.7% in the FPFC group and 93.3% in the PPAC group (P = 0.976). At postoperative 12 months, the graft success rates were 96.7% in the FPFC group and 83.3% in the PPAC group (P = 0.182). However, the residual and re-perforation rate with no infection was 0.0% (0/31) in the FPFC group and 16.7% (5/30) in the PPAC group (P = 0.056). No significant between-group differences were observed pre- (P = 0.842) or post- (P = 0.759) operative air bone gap (ABG) values or mean ABG gain (P = 0.886). However, granular myringitis has been noted in 6.5% in the FPFC group and in 3.3% in the PPAC group., Conclusions: This study suggested that 12-month graft success and hearing gain were comparable between the perichondrium free and partial attachment the cartilage graft techniques, nevertheless, partial attachment technique could increase residual and re-perforations., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: The objective of this study was to compare the postoperative infection and graft success rates, and the hearing improvement, after endoscopic cartilage underlay myringoplasty with versus without antibiotic ointment coating., Materials and Methods: This was a retrospective case-control study. The clinical records of patients who underwent endoscopic cartilage underlay myringoplasty and who met the selection criteria were retrieved and divided based on middle ear packing status into groups with antibiotic ointment packing (AOP group) and with no antibiotic ointment packing (no-AOP group). The operation time, postoperative infection, graft success status, and hearing improvement were compared between the 2 groups., Results: Patients with 166 perforations constituted the AOP group, and patients with 141 perforations comprised the no-AOP group. At 3 months postoperatively, middle ear infections had occurred in 24 (14.5%) ears in the AOP group and 4 (2.8%) ears in the no-AOP group ( P  < .01). At 12 months postoperatively, the graft success rate was 81.3% in the AOP group and 97.9% in the no-AOP group ( P  < .01). No significant group differences were observed, preoperatively ( P  = .657) or postoperatively ( P  = .578), in the air-bone gap (ABG) values or mean ABG gains ( P  = .758)., Conclusion: Middle ear packing without antibiotic ointment coating does not increase the postoperative infection rate or reduce the graft success rate after endoscopic cartilage underlay myringoplasty compared to antibiotic ointment coating. On the contrary, coating with antibiotic ointment increases the risk of postoperative infection given the complexity of middle ear manipulation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Conclusion: Acellular dermal matrix (ADM) can be used as a substitute for tympanic membrane (TM) reconstruction. Objective: To investigate the effectiveness of ADM in the treatment of TM perforations. Methods: Fifty guinea pigs were used to create TM perforations. The perforations of the left TM were repaired with ADM by patch technique in 28 guinea pigs and by underlay technique in 22 guinea pigs. The right ears were used as the control group by establishing TM perforation but without TM reconstruction. The morphological and structural status of the grafts was observed by immunohistochemistry and scanning electron microscopy. Results: There was no statistically significant difference in TM perforation closure between the ADM patch technique group and the ADM underlay technique group, but these groups had a higher success rate in closing TM perforation than the control group. The healed TMs with ADM had the same characteristics as normal TM on histological examination. [ABSTRACT FROM AUTHOR]