Authors: Emily Iacovou Petros V Vlastarakos George Papacharalampous Efthymios Kyrodimos Thomas P Nikolopoulos
Publish Date: 2013/01/16
Volume: 270, Issue: 11, Pages: 2803-2813
Abstract
The aim of this study was to compare the hearing results and graft integration rates in patients undergoing myringoplasty for the reconstruction of the tympanic membrane with the use of either cartilage or temporalis muscle fascia TMF A systematic literature review in Medline and other database sources up to February 2012 was carried out and the pooled data were metaanalyzed Twelve studies were systematically analyzed One represented level I one level II and ten level III evidence The total number of treated patients was 1286 Cartilage reconstruction was used in 536 TMF in 750 cases Two level III studies showed a significant difference between the pre and postoperative airbone gap closure in favor of cartilage grafting The mean graft integration rate was 924 in the cartilage group and 843 in the TMF group p 005 The rates of reperforations were 76 and 155 respectively p 005 Among the other complications of type I tympanoplasty retraction pockets otitis media with effusion anterior blunting and graft lateralization were usually surgically managed whereas most of the rest were minor and could be dealt with conservatively The graft integration rate in myringoplasty is higher after using cartilage in comparison with fascia reconstructions grade C strength of recommendation and the rate of reperforation is significantly lower Although cartilage is primarily used as grafting material in cases of Eustachian tube dysfunction adhesive otitis media and subtotal perforation in everyday surgical practice a wider utilization for the reconstruction of the tympanic membrane in myringoplasties can be recommended
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