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- Title
Double-Layer Tympanic Membrane Graft in Type I Tympanoplasty.
- Authors
Bedri, Es-hak; Korra, Bilen; Redleaf, Miriam; Worku, Alemayehu
- Abstract
Background: Some discussion remains among otologists regarding the best grafts for tympanic membrane closure. It is unclear whether double-layer grafts are superior to single-layer and whether single-layer cartilage is superior to fascia or perichondrium alone. The objective of the current study was to examine the relative efficacy of single-layer versus double-layer tympanic membrane grafting techniques. Materials and Methods: A retrospective review of the medical records was used to address the objective of the study. Patients operated on in an over/under technique by the same surgeon underwent single-layer perichondrium or single-layer perichondrium with a cartilage island, or a double-layer of perichondrium combined with periochondrium with a cartilage island. The outcomes assessed were tympanic membrane reperforation and hearing improvement. Results: A total of 135/177 (76%) perichondrium grafts had no reperforation, and 43/55 (78%) perichondrium with cartilage island grafts had no reperforation; 352/390 (90%) of the double-layer closures had no reperforation. There was no statistically significant difference in reperforation rates between the 2 single-layer techniques (P =.926). The difference in reperforation rates after the double-layer closure versus the perichondrium single-layer closure was statistically significant (P =.001), as was the difference in reperforation rates after the double-layer closure versus the cartilage island single-layer closure (P =.02). All 3 groups showed statistically significant hearing improvement postoperatively (P <.0001). Preoperative hearing levels (P =.179), postoperative hearing (P =.857), and decibels of hearing improvement (P =.356) were the same for all 3 groups. Conclusion: Double-layer closure gives lower tympanic membrane reperforation rates than does single-layer closure, as well as similar hearing outcomes.
- Subjects
CARTILAGE transplantation; COMPARATIVE studies; HEARING; POSTOPERATIVE period; TRANSPLANTATION of organs, tissues, etc.; TYMPANOPLASTY; STATISTICAL significance; TREATMENT effectiveness; RETROSPECTIVE studies; PREOPERATIVE period; DESCRIPTIVE statistics; TYMPANIC membrane perforation
- Publication
Annals of Otology, Rhinology & Laryngology, 2019, Vol 128, Issue 9, p795
- ISSN
0003-4894
- Publication type
Article
- DOI
10.1177/0003489419843551