Cartilage palisade type 1 tympanoplasty: Anatomical and audiological outcomes

Abstract

Objectives: To evaluate the anatomical (an intact tympanic membrane without atelectasis or lateralization) and audiological outcomes of type 1 cartilage palisade tympanoplasty. Methods: The prospective study was done at a tertiary referral institute included 30 patients with mucosal type chronic otitis media requiring type 1 tympanoplasty including subtotal or total perforations and revision cases. The tympanic membrane reconstruction was done using full thickness broad cartilage palisades harvested from the tragus or concha with attached perichondrium laterally. Patients were assessed at 1st, 3rd and 6th postoperative months for assessment of graft uptake, healing of tympanic membrane and hearing evaluation using pure tone audiometry. Results: Total 27 out of 30 patients had fully epithelized completely healed grafts postoperatively at 1 month (success rate of 90%) while three patients had small defect. One out of these three patients showed complete healing of graft while remaining two had persistent defect at 3rd and 6th months postoperatively. The mean pure tone air bone gap considerably reduced from 33.27 ± 4.29 dB preoperatively to 12.67 ± 5.68 dB postoperatively at 6 months. Conclusion: Tympanic membrane reconstruction using full thickness palisades of cartilage provides good anatomical and audiological results with significant improvement of hearing specially in cases of subtotal or total perforations, revision surgery, atelectasis and Eustachian tube disorders where healing of tympanic membrane has much poorer prognosis irrespective of the surgical technique used.