John L. Dornhoffer, MD: No relevant relationships to disclose.
PROGRAM DESCRIPTION: Many graft materials are available for the reconstruction of tympanic membrane (TM) defects, with temporalis fascia and perichondrium representing the most commonly used. In certain situations, however, such as atelectatic TM, cholesteatoma, and revision cases, results with the more traditional materials have not been as gratifying. Cartilage, because of its more rigid quality, tends to resist resorption and retraction in these more difficult cases. While the concept of tympanic membrane reconstruction with cartilage is not new, its routine acceptance as an alternative graft material has been hampered by a lack of understanding of the surgical indications, techniques, and functional results of this material.
To date, we have performed over 5000 cartilage tympanoplasties at the University of Arkansas for Medical Sciences and Arkansas Children’s Hospital (Little Rock, AR). We have found the functional results with regard to hearing and graft-take to be excellent compared to the more traditional techniques. Both the perichondrium island flap and the palisade reconstruction, with cartilage harvested from the tragus and concha, respectively, have been utilized and proven advantageous in TM reconstruction. The palisade technique has proven useful when ossiculoplasty is performed whereas the island flap is utilized in large perforations and atelectatic ears. This course will provide instruction in surgical indications, both cartilage techniques, outcome, and complication management.
This course will teach techniques of cartilage tympanoplasty as performed in over 5000 cases at the University of Arkansas for Medical Sciences in the United States. Emphasis will be on patient selection, surgical technique, outcome, and complication management. Both the palisade technique, used with ossicular reconstruction, and the island flap, the technique preferred for the atelectatic ear and recurrent perforations, will be discussed.
Digital video and photography incorporated into a PowerPoint presentation will be used in conjunction with an open question and answer format.
OUTCOME OBJECTIVE 1: Be familiar with the surgical decision-making with cartilage tympanoplasty and indications for the two different techniques.
OUTCOME OBJECTIVE 2: Learn both the palisade and cartilage island flap techniques with regard to graft harvest, preparation, and placement, with and without ossiculoplasty.
OUTCOME OBJECTIVE 3: Understand anticipated outcome and complication management, such as post-operative tube placement.
BACKGROUND STATEMENT: This course has received excellent scores for over 20 years at the Academy of Otolaryngology-Head and Neck Surgery meetings.
