Chondro-perichondrial connection in middle ear surgery

Hearing conservation or gain are important parameters of tympanoplastic surgery. The frequency of this surgical procedure and the difficulty in obtaining tissues due to the increased risk of H.I.V. transfer has made the use of synthetic products somewhat more acceptable in contrast with the use of organic substances (homograft ossicles, bone, cartilage and perichondrium, etc...). We have been using tissues of the same patient (50), during a period of three years with a specimen constituted of cartilage and perichondrium designed as a "butterfly" and with very promising tympanoplastic and functional results. The tympanoplastic results were evaluated eighteen months postoperatively as follows: good: 86%, aural discharges that disappeared later 12%, perforations: 0%, keratin neoformations: 2%. Functional results were evaluated three years later as follows: gain more than 15 dB: 72%, same: 14%, worse: 14%.