Cartilage Palisade Grafting in Retrograde Canal Wall Down Mastoidectomy: A Review of 80 CasesPradeep Pradhan1* and Priti Lal2
- *Corresponding Author:
- Pradeep Pradhan
MS (ENT), Department of Otorhinolaryngology
All India Institute of Medical Sciences
Bhubaneswar, Odisha, India
Tel: 91 9968634053
E-mail: [email protected]
Received date: March 07, 2017; Accepted date: March 30, 2017; Published date: April 06, 2017
Citation: Pradhan P, Lal P (2017) Cartilage Palisade Grafting in Retrograde Canal Wall Down Mastoidectomy: A Review of 80 Cases. Otolaryngol (Sunnyvale) 7:302. doi:10.4172/2161-119X.1000302
Copyright: © 2017 Pradhan P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distributionand reproduction in any medium, provided the original author and source are credited.
Objective: Although synthetic grafts have been extensively used for tympanoplasty in canal wall down mastoidectomy, a substantial proportion of the patients show graft extrusion. Conchal cartilage grafts can be effectively used for the above purpose for a better graft uptake and hearing gain. Here, anatomical and functional outcomes have been assessed in 80 patients undergoing retrograde canal wall mastoidectomy with cartilage tympanoplasty. Material and methods: This study was conducted in a tertiary care referral hospital during the period from July 2012 to June 2015. A total 80 patients of active squamous disease with conductive hearing had undergone canal wall down mastoidectomy. Pure tone audiogram and speech reception thresholds were carried out in preoperative and each postoperative visit i.e. at 3, 6, 12 months of surgery. ≥ 10 dB closure of air-bone (AB) gap and ≥ 10 dB improvement in speech reception threshold were considered significant. Results: Out of 80 patients, 58 (72.50%) were males and 22 (27.50%) were females and 68 (85.00%) were fresh cases and 12 (15.00%) were revision cases. Overall closure of the tympanic membrane was achieved in 76 (95.00%) cases. At the end of 12 months, mean air conduction threshold was 34.30 dB with 8.2 dB closures of AB gap was found in new cases and 35.08% of them had significant improvement in hearing. Again the mean air conduction thresholds for the revision cases was 40.8 dB with 6.9 dB closure of AB gaps noticed at the end of 12 months and 25% of the them had significant improvement in hearing (≥ 10 dB closure). Conclusion: Autologous conchal cartilage can be used for the tympanic membrane grafting in patients undergoing canal wall down mastoidectomy with minimal rejection rate. Although significant improvement in hearing was achieved in 33.80% cases, almost all had social serviceable hearing till the end of 12 months.