Postauricular undersurface tympanic membrane grafting: a follow-up report

Area of Science:

• Otolaryngology
• Surgical Innovation

Background:

• Chronic ear disease often necessitates tympanic membrane grafting.
• Assessing graft success rates and complications is crucial for surgical outcomes.
• Postoperative retraction pockets and recurrent cholesteatoma remain challenges in tympanoplasty.

Purpose of the Study:

• To evaluate the success rate of tympanic membrane grafting in chronic ear surgeries.
• To analyze factors influencing graft take rate.
• To introduce and assess a novel cartilage tympanoplasty technique for managing tympanic membrane retraction pockets.

Main Methods:

• Retrospective review of 1,939 chronic ear surgeries, with 1,556 involving tympanic membrane grafting.
• Analysis of graft take rates considering patient age, infection, cholesteatoma, polyps, and granulation tissue.
• Description and evaluation of a cartilage tympanoplasty procedure using tragal cartilage for retraction pockets.

Main Results:

• An overall tympanic membrane graft take rate of 93% was achieved.
• Graft success was not significantly affected by patient age, infection, or cholesteatoma.
• Complications were minimal and primarily disease-related, not technique-related.
• The cartilage tympanoplasty demonstrated a marked reduction in postoperative retraction pockets and recurrent cholesteatoma over a 2-year follow-up.

Conclusions:

• Tympanic membrane grafting is highly successful in chronic ear surgery, irrespective of disease complexity.
• Autogenous and homograft fascia yield comparable graft take rates.
• Cartilage tympanoplasty offers a promising solution for preventing postoperative retraction pockets and recurrent cholesteatoma.