2020, Number 4
<< Back Next >>
Acta de Otorrinolaringología CCC 2020; 48 (4)
Surgical results of type I tympanoplasty during 2014 to 2019, at Hospital Universitario Clínica San Rafael, Bogotá
Monsalve MD, Macías TC
Language: Spanish
References: 24
Page: 303-309
PDF size: 226.80 Kb.
ABSTRACT
Introduction Tympanic perforations are a frequent otological pathology in both adult
and pediatric populations. Damage to the tympanic membrane can be caused by
various factors such as explosions, penetrating trauma, barotraumas, and infections.
The most common symptoms include tinnitus, aural fullness, and hearing loss. In
cases where surgical treatment is necessary, tympanoplasties are chosen. The objective
of this study is to determine the effectiveness of anatomical closure through
this technique. Additionally, to identify the associated comorbidities, the causes for
which the surgical procedure was decided to be performed, and the sociodemographic
characteristics of the intervened population.
Main objective: to determine the
frequency of postoperative tympanic perforations early (three months) and late (six
months), in patients who underwent type I tympanoplasty in the ENT department of
the San Rafael Clinical University Hospital in Bogotá, Colombia, during the years
2014 to 2019.
Materials and methods: a retrospective, descriptive and cross-sectional
study, that included adult and pediatric patients of the otolaryngology service of
the San Rafael Clinical University Hospital of Bogotá, Colombia, with a history of
tympanic perforations during the years 2014 to 2019 and who were operated with
type I tympanoplasty were evaluated. Post-surgical results were evaluated. mainly
the post-surgery perforations with “over-under” medial technique using ear cartilage
graft and temporal fascia.
Results: 47 patients were included in the study, of which
62% were female and 91% were older than 7 years. The percentage of reperforation
was 8.5%, that is, 4 of 47 patients, and at 12.8 months on average. The most frequent
cause of tympanic perforation was infectious with 66% and medium size 55.3%. The
most frequent otolaryngological comorbidity was chronic otitis media with 51%.
The audiological results showed a gain of 17% in the right ear and 20% in the left
ear.
Conclusions: Type I tympanoplasty with over under technique is considered
successful for the anatomical closure of the tympanic perforations, evaluated at 3
and 6 months postoperatively, with percentages that are equal to those reported in
similar studies in the literature. The audiometric results did not show a statistically
significant improvement in both ears, so studies should continue to evaluate other
factors associated with perforations such as chronic otitis media and cholesteatoma,
among others.
REFERENCES
Tseng CC, Lai MT, Wu CC, Yuan SP, Ding YF. Comparisonof the efficacy of endoscopic tympanoplasty and microscopictympanoplasty: A systematic review and meta-analysis.Laryngoscope. 2017 Aug 1;127(8):1890–6.
2 Bedoya L, Mejía L, Duarte L. Factores relacionados atimpanoplastia fallida en el Hospital Universitario de LaSamaritana. Acta de Otorrinolaringología & Cirugía de Cabezay Cuello. 2014; 42(4): 216-221
Elías Ordóñez-Ordóñez L, Vitery Erazo L, Ricardo GonzálezMarín N, Parra Valencia DP, Rueda Rs. Timpanoplastia enperforación timpánica secundaria a trauma por onda explosiva.Revista Med Universidad Militar Nueva Granda, 2014, vol. 22.
Aupy B, Clément P, Crambert A, Roguet E, ConessaC. Traumatismo auricular por onda expansiva. EMC -Otorrinolaringología. 2013 Aug;42(3):1–9.
Lou ZC, Lou ZH, Zhang QP. Traumatic tympanic membraneperforations: A study of etiology and factors affecting outcome.American Journal of Otolaryngology - Head and Neck Medicineand Surgery. 2012;33(5):549–55.
Orji FT&, Agu CC. Determinants of spontaneous healing intraumatic perforations of the tympanic membrane. ClinicalOtolaryngology 2008 vol. 33.
Webb BD, Chang; C Y Joseph. Efficacy of TympanoplastyWithout Mastoidectomy for Chronic Suppurative Otitis Media.Arch Otolaryngol Head Neck Surg. 2008. Vol. 134.
Eliades SJ, Limb CJ. The role of mastoidectomy in outcomesfollowing tympanic membrane repair: A review. Laryngoscope.2013. p. 1787–802.
Callioglu EE, Tijen Ceylan B, Kuran G, Demirci S, Tulaci KG,Caylan R. Cartilage graft or fascia in tympanoplasty in patientswith low middle ear risk index (anatomical and audologicalresults). European Archives of Oto-Rhino-Laryngology. 2013Nov;270(11):2833–7.
Salviz M, Bayram O, Bayram AA, Balikci HH, Chatzi T, PalturaC, et al. Prognostic factors in type I tympanoplasty. Auris NasusLarynx. 2015 Feb 1;42(1):20–3.
Iacovou E, Vlastarakos P v., Papacharalampous G, KyrodimosE, Nikolopoulos TP. Is cartilage better than temporalis musclefascia in type I tympanoplasty? Implications for current surgicalpractice. European Archives of Oto-Rhino-Laryngology. 2013.p. 2803–13.
Yilmaz MS, Guven M, Kayabasoglu G, Varli AF. Comparisonof the anatomic and hearing outcomes of cartilage type 1tympanoplasty in pediatric and adult patients. EuropeanArchives of Oto-Rhino-Laryngology. 2015;272(3):557–62.
Ryan MA, Kaylie DM. What is the optimal age to repairtympanic membrane perforations in pediatric patients?Laryngoscope. 2016. p. 2201–2.
Lagos A, Villarroel P, García-Huidobro F, Delgado V, HuidobroB, Caro J, et al. Tympanoplasty: factors associated withanatomical and audiometric results. Acta OtorrinolaringologicaEspanola. 2020.
Darouassi Y, Aljalil A, Ennouali A, Hanine MA, Chebraoui Y,Bouaity B, et al. Prognostic factors of myringoplasty: Studyof a 140 cases series and review of the literature. Pan AfricanMedical Journal. 2019;33.
Iacovou E, Vlastarakos P v., Papacharalampous G, KyrodimosE, Nikolopoulos TP. Is cartilage better than temporalis musclefascia in type I tympanoplasty? Implications for current surgicalpractice. European Archives of Oto-Rhino-Laryngology. 2013.p. 2803–13.
Lin Y-C, Wang W-H, Weng H-H, Lin Y-C. Predictors ofSurgical and Hearing Long-term Results for Inlay CartilageTympanoplast. Arch Otolaryngol Head Neck Surg. 2011.
Heo KW. Outcomes of type I tympanoplasty using a cartilageshield graft in patients with poor prognostic factors. AurisNasus Larynx. 2017 oct 1;44(5):517–21.
Fernandes VLG, Goel HC, de Sousa E, de Gouveia Pinto NM.A Comparative Study of Type-I Underlay Tympanoplasty withTemporalis Fascia Graft Alone and with Conchal Cartilage.Indian Journal of Otolaryngology and Head and Neck Surgery.
2019 Nov 1; 71:1320–6.20. Gao T, Li X, Hu J, Ma W, Li J, Shao N, et al. Managementof traumatic tympanic membrane perforation: A comparativestudy. Therapeutics and Clinical Risk Management. 2017 Jul24; 13:927–31.
Shah, M.I. & Ghani, R. & Asif, M. Type-I Tympanoplasty ByUnderlay Technique - Factors Affecting Outcome. Journal ofAyub Medical College, Abbottabad: JAMC. 29. 258-261.
Tan HE, Santa Maria PL, Eikelboom RH, AnandacoomaraswamyKS, Atlas MD. Type I Tympanoplasty Meta-Analysis: ASingle Variable Analysis. Otology and Neurotology. 2016 Aug1;37(7):838–46.
Hardman J, Muzaffar J, Nankivell P, Coulson C. Tympanoplastyfor Chronic Tympanic Membrane Perforation in Children:Systematic Review and Meta-analysis. Otology & Neurotology.Otology & Neurotology, Inc; 2015.
Babu S, Luryi AL, Schutt CA. Over–under versus medialtympanoplasty: Comparison of benefit, success, and hearingresults. Laryngoscope. 2019 May 1;129(5):1206–10.