Type III tympanoplasty applying the palisade cartilage
technique: a study of 61 cases
Neumann A., Schultz-Coulon H.-J., Jahnke K.
Published: Otol Neurotol. 2003 Jan;24(1):33-7.
Objective: To determine the morphologic and hearing results of the combined
application of the palisade cartilage technique and titanium ossicular
replacement prostheses in Type III tympanoplasty.
Study Design: Retrospective review of 61 tympanoplasties.
Setting: Tertiary referral center.
Patients: 59 patients (39 women and 20 men, mean age 36 years, range 7-81
years) consecutively operated on because of cholesteatoma, adhesive otitis,
chronic otitis media, subtotal tympanic membrane defects, and tympanofibrosis
requiring tympanoplasty with ossiculoplasty.
Interventions: Tympanoplasty Type III, with application of the palisade cartilage
technique and total or partial titanium ossicular replacement prosthesis.
Main Outcome Measures: Otoscopic findings and hearing results using a
four-frequency pure tone average air-bone gap.
Results: A recurrent defect was seen in 1 ear (1.6%). The graft take rate was
100%. There were no extrusions of prostheses. Preoperatively, a pure tone
average air-bone gap of 0 to 10 dB was seen in 1 ear, 11 to 30 dB in 30, and
31 to 50 dB in another 30 ears. Postoperatively, the corresponding numbers
were 11, 41, and 9 ears, respectively. Hearing results were better in the total
ossicular replacement prosthesis group.
Conclusion: The palisade cartilage technique is suitable to manage difficult
pathologic conditions in middle ear surgery. It was demonstrated that the
palisade cartilage technique can be combined safely with titanium ossicular
replacement prostheses. Regarding postoperative hearing results, the negative
preselection of pathologic conditions must be considered.