Our Summary

This research aimed to compare the success rate of a type of ear surgery (called tympanoplasty) in various groups: adults vs. children, using cartilage vs. fascia (a type of connective tissue) grafts, and using two different surgical techniques (overlay vs. underlay).

The study included 198 patients (208 ears). The success of the surgery was judged by whether the graft was fully taken up by the body and any complications. The results showed that the surgery was successful in 200 ears (96% success rate).

The success rate was slightly higher in adults compared to children and in the cartilage graft group compared to the fascia group. However, these differences were not statistically significant, meaning they could have occurred by chance.

In terms of the surgical technique, all surgeries using the overlay technique were successful, while the underlay technique had a 95% success rate. Again, this difference was not statistically significant.

In simple terms, the study found that the type of graft, the age of the patient, and the surgical technique do not significantly impact the success rate of tympanoplasty surgery.

FAQs

  1. What is the success rate of tympanoplasty in adults compared to pediatric patients?
  2. Is there a significant difference in the graft take rate between cartilage and fascia grafts in tympanoplasty?
  3. What is the success rate of graft take in overlay tympanoplasty compared to underlay tympanoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about tympanoplasty is to follow post-operative care instructions carefully to promote successful graft take and reduce the risk of complications. This can include keeping the ear dry, avoiding activities that may increase pressure in the ear, and attending follow-up appointments as scheduled. Additionally, patients should report any unusual symptoms or concerns to their doctor promptly.

Suitable For

Patients who are typically recommended tympanoplasty are those with eardrum perforations or chronic middle ear infections that have not responded to other treatments. This study found that overall, graft take rate after tympanoplasty was high in both adults and paediatric patients, with slightly higher success rates in adults and with cartilage grafts compared to fascia grafts. The study also found that overlay tympanoplasty had a 100 per cent success rate, while underlay tympanoplasty had a success rate of 95 per cent.

Timeline

Before tympanoplasty:

  1. Patient presents with symptoms of hearing loss, ear pain, ear discharge, or recurrent ear infections.
  2. Patient undergoes a thorough examination by an otolaryngologist, including a physical examination and possibly imaging tests such as a CT scan or MRI.
  3. Diagnosis of a perforated eardrum is made, and tympanoplasty is recommended as a treatment option.

After tympanoplasty:

  1. Surgery is performed, either using a cartilage or temporalis fascia graft, and either an overlay or underlay technique.
  2. Patient is monitored post-operatively for any complications such as infection or graft rejection.
  3. Follow-up appointments are scheduled to assess the success of the surgery, including checking for full graft take.
  4. In most cases, full graft take is achieved, with a success rate of 96% in the study.
  5. Patients may experience improved hearing and resolution of symptoms such as ear pain or discharge after successful tympanoplasty.

What to Ask Your Doctor

  1. What is tympanoplasty and why do I need it?
  2. What are the different types of tympanoplasty techniques (underlay vs overlay) and which one is recommended for me?
  3. What are the potential risks and complications associated with tympanoplasty?
  4. How long is the recovery period after tympanoplasty and what can I expect during the healing process?
  5. How successful is tympanoplasty in terms of full graft take and overall outcomes?
  6. Will I need any follow-up appointments or additional procedures after tympanoplasty?
  7. Are there any restrictions or precautions I should take after the surgery to ensure optimal healing?
  8. How experienced are you in performing tympanoplasty procedures and what is your success rate?
  9. Are there any alternative treatment options available for my condition other than tympanoplasty?
  10. Can you provide me with more information about the specific type of graft material (cartilage or fascia) that will be used in my surgery and the reasons for choosing that material?

Reference

Authors: Odat H, Alali M, Kanaan Y, Al-Qudah M. Journal: J Laryngol Otol. 2021 Apr;135(4):315-319. doi: 10.1017/S0022215121000645. Epub 2021 Mar 11. PMID: 33691826