Cartilage in Tympanoplasty
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The author has used cartilage grafts for several indications in tympanoplasty. This series of 282 tvmpatioplasties performed from 1985 to 1996 reports the technical modalities used and the functional results obtained. 12 autogenic and allogenic (homologous) cartilage grafts removed from the middle car after a time ranging from 2 to 8 years were studied by light microscopy together with a comparative histological examination between fresh and preserved cartilages. Separate cartilage used as a columclla or as a bridge for minor includal defects were subjected to poor nutrition with subsequent absorption and fibrous tissue replacement Composite cartilage-perichondrial grafts or separate cartilage in contact with the drum had better nourishment and retained viability with possible ossification. Preservation of cartilage in 70% alcohol did not alter its permanent characteristics and our result justified its use in tympanoplasty. Composite cartilage-perichondrial grafts were successfully applied in reconstruction of attic or canal wall defects and in management of retraction pockets, atelectatic or perforated drums. They showed a high take rate, long term viability and minimal inflict on hearing results. Septrate autologous or homologous cartilage, on the other hand, are advised for minimizing alloplastic extrusion and augmenting stapedial head.