Long-term anatomic and functional results of cartilage tympanoplasty in atelectatic ears

The purpose of this study was to analyze the anatomic and functional results of cartilage tympanoplasty performed on atelectatic ears using the palisade technique and to assess the long-term efficacy of cartilage palisades in preventing recurrent retractions. The records of 54 patients (56 ears) who underwent surgery for atelectasis with or without mastoidectomy from January 2000 to August 2005 were retrospectively evaluated. A successful outcome was defined as complete and intact healing of the graft without perforation, retraction, or lateralization for at least 36 months after the operation, in addition to improvement of hearing indicated by a pure-tone average air-bone gap (PTA-ABG) of less than 20 dB. The mean follow-up period was 44.5 +/- 8.0 months (range, 36-68 months). Closure of the tympanic membrane was achieved in 91% of ears. Otomicroscopic evaluation revealed nine (16%) mild and five (8%) moderate retractions, but none of the retractions was deep enough to necessitate tube placement. Postoperative PTA-ABG was less than 20 dB in 71% of ears. The average preoperative and postoperative ABG values, including all types of tympanoplasty operations (Type I, II and III), were 28.4 +/- 5.8 and 16.9 +/- 6.7 dB, respectively (p < 0.001). No significant difference in the change in PTA-ABG was found between the groups with or without mastoidectomy (p > 0.05). Palisade cartilage tympanoplasty is an effective technique for tympanic membrane closure and hearing improvement in atelectatic ears. Mastoidectomy does not change the anatomic or audiologic findings in these types of ears. We recommend this technique to other otologic surgeons.