Cartilage-Perichondrium Tympanoplasty for Pediatric Atelectatic Ears

Jang, Chul Ho; Kim, Jong Kil

Abstract

BACKGROUND AND OBJECTIVES: Pediatric atlectasis of the pars tensa occurs fairly commonly in patients with previous ear disease, especially otitis media with effusion. The atelectatic ears have been classified into four grades. For grades 3 and 4 atlectasis, for which it is difficult to manage by conservative treatment, some surgeons suggest fascia and perichondrium grafts to reinforce thin atrophic tympanic membranes. In such situations, fascia and perichondrium are often shown to undergo atrophy and subsequent failure in the postoperative period. In this study, we attempted to assess the efficacy of cartilage-perichondrium tympanoplasty for pediatric atelectatic. We used cartilage-perichondrium for graft because it was more rigid and it tended to resist resorption and retraction even in the face of continued eustachian tube dysfunction. MATERIALS AND METHOD: Twenty one patients who underwent cartilage-perichondrium tympanoplasty were assessed retrospectively.
RESULTS
The atelectatic ears were elevated and everted in all patients. The air-bone gap was less than 10 dB in 57%, and less than 20 dB in 33% of the patients observed. The postoperative CT showed a well placed graft with good ventilated middle ear cavity and mastoid cavity.
CONCLUSION
It can be suggested from this study that the cartilage-perichondrium tympanoplasty offers the possibility of rigorous drum reconstruction with excellent postoperative hearing results.