Influence of the palisade technique for tympanic membrane reconstruction on the vibratory capacity and self-resonance of the middle ear system and the postoperative pure tone audiogram

Introduction Cartilage palisades can be used to reconstruct tympanic membrane defects (tympanoplasty type I), although doubts have always been raised about the acoustic properties of palisades. The aim of the study was to evaluate the cartilage palisade technique in terms of hearing improvement, vibratory ability and resonance frequency of the middle ear system.

Methods Patients after tympanoplasty type I using the palisade technique, with a healthy opposite ear at the time of postoperative follow-up, were studied. The effect of the surgery was evaluated by the pre- and postoperative air-bone gap (ABG). In addition, the compliance maximum from standard tympanometry, as a measure of the tympanic membrane’s ability to vibrate, and the resonance frequency of the middle ear system, measured by multi-Hz tympanometry, of the operated and non-operated ears were comparatively considered in a subgroup of patients.

Results In 60 patients (29 ♀; 31 ♂; 45.5 ± 19 years), surgery showed a significant decrease in ABG of 7.5 ± 9.1 dB. Multi-Hz tympanometry (n=10; 5 ♀; 5 ♂; 62 ± 13 years) showed a significant difference between the operated and non-operated ears with respect to the compliancy maximum. Evaluation of resonance frequency showed no significant difference between the two groups.

Conclusion Satisfactory hearing improvement can be achieved using the palisade technique. The resonance frequency of the neo-eardrum is similar to the natural eardrum, although the compliance maximum is significantly reduced in the operated ears.

Publication History

Article published online:
12 May 2023