[Preliminary functional results of tympanoplasty with palisade cartilage]

Total or subtotal reconstruction of the tympanic membrane with cartilage palisades counteracts the tendency to retraction observed in ears with functional problems of the tube or altered gas exchange of the mucosa, in contrast with "soft" autologous materials such as temporal fascia or perichondrium. Because of its low turnover, cartilage is more resistant to the prolonged absence of neovascularization from the periphery in (sub) total perforation making it more resistant to infection. However, the use of palisade cartilage has been questioned for the functional recuperation of the middle ear because of its rigidity and thickness. A retrospective study was made of the functional results of 148 type III tympanoplasties with partial or complete reconstruction with cartilage after a one-stage procedure. A comparison of 108 ears with a mean postoperative follow-up of 20 months and 40 ears with a mean follow-up of more than 6 months showed no statistically significant difference in the overall functional results. A "social" hearing level (GAP < 30 dB) was achieved in 83.2%: the gain was 1-30 dB in 75.6% of cases (n = 112). No statistically significant differences were found between the functional results of primary surgery and re-operation. Statistically significant differences were found in the functional results of canal wall down and canal wall up procedures.