Long-Term Results of Palisade Cartilage Tympanoplasty

OBJECTIVE: Evaluation of morphologic and functional long-term results of palisade cartilage tympanoplasty (PCT) combined with titanium ossicular replacement prostheses. STUDY DESIGN: Retrospective review of tympanoplasties. SETTING: Tertiary referral center. PATIENTS: Twenty-nine patients (12 women and 17 men; mean age, 39 yr; range, 17-72 yr) operated on more than 9 years ago (mean follow up, 9.1 yr) because of cholesteatoma, adhesive otitis, chronic otitis media, subtotal tympanic membrane defects, and tympanic fibrosis requiring tympanoplasty. INTERVENTIONS: Tympanoplasty, applying the PCT. For ossiculoplasty, total or partial titanium ossicular replacement prostheses were used. MAIN OUTCOME MEASURES: Questionnaire on postoperative course, otoscopic findings, and hearing results using a 4-frequency pure-tone average air-bone gap. RESULTS: A recurrent defect was not observed. The graft take rate was 100%. There was one case of prosthesis protrusion which required revision surgery and insertion of a shorter prosthesis. A pure-tone average air-bone gap of 0 to 10 dB was seen preoperatively in 1 ear, 11 to 30 dB in 16 ears, and 31 to 59 dB in 12 ears. Postoperatively, the corresponding numbers were 10, 15, and 4 ears. CONCLUSION: The PCT is a reliable surgical method to manage difficult middle ear pathology on a long-term (>9 yr) basis. It offers satisfactory morphologic and functional results in combination with titanium prosthesis ossiculoplasty.