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Cartilage tympanoplasty in smokers
Daniel H Coelho1, Angela Peng, Meghan Thompson
1Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia 23298-0146, USA. dcoelho@mcvh-vcu.edu
The Annals of Otology, Rhinology, and Laryngology
|November 8, 2012
Summary
Cartilage tympanoplasty shows similar success rates in smokers and nonsmokers. For smokers, cartilage grafts are recommended, offering better outcomes than non-cartilage grafts.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Patient Outcomes
Background:
- Smoking is a known risk factor for poorer outcomes in otologic surgery.
- Cartilage tympanoplasty is an established technique for eardrum reconstruction.
Purpose of the Study:
- To compare the outcomes of cartilage tympanoplasty between smokers and nonsmokers.
- To evaluate the efficacy of cartilage grafts in smokers undergoing tympanoplasty.
Main Methods:
- Retrospective chart review of 129 cartilage tympanoplasty operations (1991-2010).
- Patients were divided into nonsmokers (84 operations) and smokers (45 operations).
- Primary outcome: tympanic membrane graft take rate; Secondary outcomes: recurrence, revision surgery, hearing outcomes.
Main Results:
- Comparable long-term graft take rates: 90.6% in nonsmokers vs. 92.9% in smokers (p=0.99).
- Trend towards higher revision rates in smokers (13.3% vs. 4.7%, p=0.09).
- Both groups showed hearing improvement; cartilage tympanoplasty success in smokers exceeded prior non-cartilage graft results.
Conclusions:
- Cartilage tympanoplasty demonstrates comparable success and audiological outcomes in smokers and nonsmokers.
- Cartilage grafting is superior to non-cartilage grafting in smokers.
- Recommended for all smokers undergoing tympanoplasty.
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