Effectiveness of cartilaginous-bending-spring-tympanoplasty for reconstruction of anterior defects – a prospective randomised clinical trial

Introduction Anterior tympanic membrane defects present a surgical challenge due to the lack of graft support associated with reduced success rates of established tympanoplasty (ET) techniques that anchor the graft to the anterior rim of the tympanic membrane. The "Cartilaginous-bending-spring-tympanoplasty" (CBST) is designed to secure the graft by supporting the tympanic membrane (TM) using a C-bending-spring cartilage without reducing sound transmission. This study compares the success of CBST with ET in terms of TM closure and hearing outcome.

Materials & Methods In this randomised prospective study, from 01/03/18 to 30/09/20 patients with anterior TM defects were included and randomised to surgeon and reconstruction technique (ET vs UFT). Inclusion criterion was chronic otitis media mesotympanalis with an intact ossicular chain. Objectives were surgical success, defined as intact TM at the follow-up time point (FU), and hearing outcome.

Results 57 patients (CBST 28; ET 29) with a mean age of 44.5±14.5 years were included. The mean FU was 151±81.8 days with a closed TM in 95% of cases in both groups. Postoperative hearing was not significantly different in both groups. Hearing improvement was comparably improved in both groups (hearing threshold: ET 0.0±16.6 dB; CBST 6.7±7.4; p=0.055; sound conduction component: ET 3.3±9.3 dB; CBST6.3±6.0 dB; p=0.148).

Conclusion Reconstruction of anterior TM defects with CBST is similarly successful compared to ET. The functional hearing outcome of CBST is also comparably good, so that there is no need to fear any detrimental effect on hearing due to the support of the graft.

Publikationsverlauf

Artikel online veröffentlicht:
12. Mai 2023