The Application Of The Tragus Cartilage–Perichondrium In The Tympanoplasty

Objective:To analysis the application of the tragus cartilage– perichondrium in tympanoplasty, observe the recovery of patients’ tympanic membrane and the improvement of hearing after postoperation of tympanoplasty, and to make the tragus cartilage– perichondrium is widely used in clinic operation.Method:Between November, 2012 and November, 2013, 38 patients(male 13 and female 25) with tympanoplasty carried out tragus cartilage – perichondrium repairing tympanic membrane, in Gansu Provincial Hospital. There were 11 cases with traumatic perforation of tympanic membrane, 15 cases with chronic otitis media, 12 cases with otitis media of cholesteatoma. Operation method depended on PTA,acoustic immitance, ear endoscope, and operative exploration. There were 27 cases using myringoplasty without mastoidectomy and 11 cases using opened tympanoplasty with myringoplasty. After operation, these patients were followed up every 2 weeks. Evaluating the recovery of patients’ tympanic membrane after the operation and comparing the change of air-bone gap between pre-operative and two month after the operation.Results:31 patients successfully followed up over 6~12 months(average 6 months). 30 cases were healing by first intention(cure rate 97%). The postoperative duration of dry ear was 3 ~ 12 weeks(median 6 weeks). The decrease of ABG postoperatively >19d B. Tympanic membrane healed and looked like normal appearance in 1 to 3 months after the operation. The tragus appearance were no different between the one having an operation with the normal. After positive, 1 case met with the tympanic membrane perforation again, but the perforation healed up by the therapy of active antiinfection.Conclusions:Tympanic membrane reconstruction using the tragus cartilage-perichondrium can be a feasible therapies of tympanoplasty. The survival rate and the improvement of postoperative hearing would be ideal. But in several complex conditions, such as the middle ear with poor ventilation function, having adhesive otitis media, the application of the tragus cartilage- perichondrium is still needed to further research..