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Fate of cartilage material used in middle ear surgery light and electron microscopy study
M Hamed1, M Samir, M El Bigermy
1Department of Otolaryngology, Ain shams University, Abbasia, Cairo, Egypt.
Objective:
To evaluate the fate of autograft and homograft cartilage used in the middle ear.
Method:
Animal experimental study was carried out on 20 healthy guinea pigs by implanting small pieces of auto- and homograft costal cartilage in the middle ears for different periods of time (1, 3 and 6 months). The grafts were removed and examined by light and electron microscopy. Cartilage autografts, obtained from seven human cases at revision tympanoplasty, were also examined by light and electron microscopy.
Results:
In the animal experimental study the chondrocytes were degenerated while the matrix was preserved in both auto- and homograft specimens. The homografts were as good as the autografts as in both cases the cartilage matrix was preserved. In the human specimens obtained after 10-15 months of implantation (six cases), the matrix was preserved, the lacunae were empty and the chondrocytes were degenerated. The specimen removed after 31/2 years (one case) showed viable chondrocytes of big size with defined cell organelles.
Conclusion:
This work provides evidence for the beneficial role of cartilage in middle ear surgery as the matrix retained its structure. There is also a possibility for the chondrocytes to remain viable for a long time after implantation. It seems also that homograft cartilage is a good option during tympanoplasty and is comparable to autografts. In the animal study the homografts were as good as the autografts as in both cases cartilage matrix was preserved.